Hydronephrosis of the kidneys. Main symptoms and treatment methods

Reasons for development

The following factors can lead to the development of pathology:

Congenital anomalies. These include incorrect location of the ureter or its entry into the bladder, as well as the arteries of the kidneys and their branches
Inflammatory processes in the bladder and ureter
Urolithiasis disease
Tumor-like formations in the pelvis

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Causes of the disease

From the kidney, urine passes into the urinary tract, passes through the ureter into the bladder, and is then excreted during emptying. Problems with urine flow can occur for various reasons:

narrowing (stricture) of the ureter, “blockage” with a tumor or stone;
chronic urinary retention due to prostate adenoma;
prolonged presence of a stone in the ureter;
compression of the ureter by an accessory vessel of the lower pole of the kidney.

There is a congenital type of hydronephrosis, which is diagnosed in newborns. The pathology is associated with congenital anomalies of the urinary system.

Not all dilatation (expansion) of the maxillary sinus is hydronephrosis.

For example, pathology can appear in healthy people when the bladder is full due to drinking large amounts of liquid. This case does not talk about hydronephrosis.

The disease is chronic, so changes in the absence of timely treatment become irreversible. This is due to the fact that with mechanical compression, the kidney tissue is replaced by connective tissue, as a result of which it loses its function. If, against the background of prolonged hydronephrosis, frequent inflammatory processes or pyelonephritis occur, removal of the kidney should be considered as a source of chronic infection.

There is unilateral and bilateral hydronephrosis.

Unilateral pathology of the urinary tract occurs when there are problems with tumor compression of the ureter, compression of an accessory vessel of the ureteropelvic segment, prolonged disruption of urine outflow, the presence of a stone in the ureter, etc.

Bilateral disease appears with simultaneous damage to the ureters or difficulty in the outflow of urine at the level of the bladder. Pathology also occurs in women with cancer of the uterus (when the ureter is compressed) or abdominal organs, in patients after radiation therapy to the pelvic organs with stricture of the ureter, etc.

Types of disease

Highlight:

Unilateral hydronephrosis
Bilateral hydronephrosis

In the first case, the pyelocaliceal complex is affected only on one side, in the second - on both sides. Unilateral damage usually occurs against the background of congenital narrowing, conflict with abnormal renal vessels, as well as urolithiasis. The cause of a bilateral process can be stones, tumors or prostate adenoma.

The doctor knows how to treat kidney hydronephrosis at one stage or another. It is only important for the patient to contact a specialist as soon as possible.

Disease severity

Hydronephrosis is divided into four degrees of severity:

I degree. The initial process of pathology, when there is a violation of the outflow of urine and due to stretching of the maxillary joint. At the same time, the walls of the cups and pelvis retain their elasticity and ability to contract. Pathological changes in the first stage are reversible.
II degree. Prolonged difficulty in the outflow of urine, in which the walls of the calyces and pelvis gradually lose their elasticity, slight changes appear in the renal tubules and nitrogenous wastes in the blood increase.
III degree. The patient experiences a disruption of the normal anatomy of the maxillofacial joint, the kidney increases in size, and the parenchyma gradually atrophies. The organ begins to appear as a formation filled with urine, which still retains its functions. Nitrogen wastes increase, so kidney failure progresses. Hydronephrosis grade 3 can cause fatigue, weakness, and increased blood pressure.
IV degree. The kidney increases significantly in size, and the natural anatomy and functionality are completely disrupted. The kidney tissue is mostly replaced by coarse connective tissue. The organ is a thin-walled bladder filled with urine. In case of grade 4 hydronephrosis, it is completely removed.

Diagnostic methods

When the first symptoms of urinary outflow disturbance or pain occur, it is necessary to be examined.

The pathology is diagnosed using an ultrasound of the kidneys, which allows you to see the expansion of the organ and structures that impede the normal outflow of urine.
One of the most informative methods is computed tomography, which helps to obtain layer-by-layer sections and a three-dimensional image of the organ and the pyelocaliceal complex. When the kidney is enlarged and fluid accumulates, it is easy to diagnose hydronephrosis.
For diagnosis, a radioisotope research method is also used - nephroscintigraphy. A radioactive drug is injected into the patient's body, after which it is placed in a gamma chamber to assess the distribution of the drug in the tissues of the urinary system. The method allows you to assess the degree of pathology and determine treatment tactics.

Stages

There are 3 stages of renal hydronephrosis:

Initial.
At this stage, the pelvis gradually expands. Kidney function is not affected
Stage of pronounced manifestations of the disease.
At this stage, the pelvis and calyces are involved in the pathological process, the functioning of the kidneys is disrupted due to compression of their tissues
Terminal stage.
It is characterized by atrophy of kidney tissue. Both chronic renal failure and complete loss of kidney functionality may occur.

The doctor knows how to treat kidney hydronephrosis at one stage or another. It is only important for the patient to contact a specialist as soon as possible. With early diagnosis, the chances of a full recovery are the highest!

Stages and symptoms

As pyeloectasia progresses, it goes through several stages, each of which is accompanied by certain changes in the renal tissues and urinary system.

Initial, easy stage

At this stage, the renal pelvis of a newborn is slightly enlarged and does not interfere with the functioning of the organ. The child does not experience any unpleasant sensations, and the pathology itself can only be diagnosed using ultrasound during fetal development or immediately after birth.

Average

The second stage of the pathology is accompanied by a pronounced expansion of the pelvis, there is damage to the external tissue of the organ, its function is reduced by 40%. At this stage of the disease, severe symptoms may be present, which forces parents to consult a doctor. The child becomes restless, often cries when urinating, and there may be blood in the urine.

Third degree

The most severe stage of the disease, which is characterized by severe symptoms. The child has an enlarged pelvis and the kidney itself, significantly reduced urine production, increased body temperature, pain when urinating and other symptoms that require a medical examination. The kidney tissue is significantly damaged, and when the pelvis is greatly expanded, it puts pressure on other tissues.

Main symptoms

Most patients complain of the following manifestations of hydronephrosis:

severe pain in the lower back and abdomen, which can radiate to other parts of the body
increase in body temperature
weakness
chills
the appearance of blood clots in the urine
headaches and increased blood pressure
there may be a completely asymptomatic course when the pathology is present from birth and the body has adapted to it

The more advanced the disease, the more pronounced its symptoms become.

Important! Body temperature rises when the disease is accompanied by an infection. In this case, it is very important to carry out immediate treatment.

Symptoms of hydronephrosis may also include bloating, constant nausea and severe vomiting, increased fatigue with decreased performance.

In children, signs of the disease include:

cloudy urine
reducing the amount of daily urine
pain

Like adults, children complain of weakness, headaches, and nausea. Parents should pay close attention to the child’s health if he refuses his favorite food, games, walks, becomes lethargic and sleeps a lot.

Competent treatment of kidney hydronephrosis in an adult or child is impossible without a high-quality comprehensive examination.

Treatment method

Only a doctor should prescribe a treatment method according to the results of the diagnosis. If the enlarged renal pelvis in a newborn does not exceed 8 mm and there is no inflammatory process, the baby does not require radical treatment methods.

In this situation, only constant diagnostic monitoring and medical supervision is necessary. This group of patients, as a rule, restores their health by 6 months of life. The recovery rate is quite high - 90%.

As the pathology progresses, the doctor decides to perform surgery. As practice shows, the need for surgery occurs in 30-35% of all cases. The main goal is to create normal conditions for the outflow of urine and eliminate the consequences (vesicoureteral reflux).

Important. Children diagnosed with pyeelectasis are strictly prohibited from receiving vaccinations. In this case, the doctor develops a special program to work with such children.

If pyeelectasis is diagnosed in a newborn, vaccinations are strictly contraindicated.

Before the operation, the child must be prepared. For this, a course of antibacterial and anti-inflammatory drugs is prescribed.

Due to their age, children are prescribed special medicines based on herbs and plants; they do not cause any particular harm to health. The chance of recovery in the presence of moderate and severe disease is equal to 50:50.

Diagnostics

Competent treatment of kidney hydronephrosis in an adult or child is impossible without a high-quality comprehensive examination. Only it allows you to determine the type of disease, the degree of organ damage and other features of the pathology.

Diagnostics include:

clinical and biochemical blood tests
Analysis of urine
Kidney ultrasound
X-ray examination of the kidneys
CT and MRI
cystourethrography
radioisotope study (nephroscintigraphy)

Diagnosis of hydronephrosis

In a conversation with the patient, after collecting anamnesis, the doctor determines the diagnostic search algorithm. Upon examination, almost nothing specific can be detected, except that in advanced cases an enlarged kidney can be felt.

It is mandatory to study urine and blood in the laboratory. Diagnosis includes mandatory instrumental examination - kidney ultrasound and radiography. Ultrasound reliably reveals signs of hydronephrosis; if necessary, ultrasound examination of renal vessels is prescribed.

X-rays are performed with intravenous contrast. During the study, kidney function is assessed, it is seen how the contrast agent passes through the calyces and pelvis, where it accumulates, how long it takes to completely filter the blood (excretory urography). In some cases, contrast is injected from below through the ureter, which allows visualization of the level of narrowing (retrograde ureteropyelography). MRI and radioisotope studies are also used as diagnostics. Endoscopic ureteroscopy (examination using an endoscope, which is inserted through the urethra and bladder into the ureter) allows you to clarify all the details and see the narrowing with your own eyes before surgery.

Treatment methods

Therapy should be started as early as possible. It can be carried out by two main methods: medication and surgery. The choice of technique is made exclusively by the doctor. In this case, the specialist takes into account a number of factors, including: the degree of development of the disease, the functionality of the organ, age and other individual characteristics of the patient, the cause of hydronephrosis, etc.

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Conservative therapy

This treatment is aimed at eliminating pain, as well as fighting infection and preventing complications. It is very important to prevent the development of urolithiasis and kidney failure.

Doctors can prescribe drugs from the following groups:

antibacterial
uroseptic
anti-inflammatory

Important! It should be understood that in most cases, conservative therapy does not get rid of the cause of the disease. It is aimed only at eliminating symptoms and does not allow the pathology to become chronic.

Therapy should be started as early as possible. It can be carried out by two main methods: medication and surgery.

Surgical interventions

Operations are performed to ensure normal urine flow and kidney function.

In case of serious disorders caused by obstructed urine outflow, the following is carried out:

Stenting.
A stent, which is a flexible and thin tube, is placed in the ureter. It ensures the free flow of urine from the kidney to the bladder. The tube begins in the pelvis area and ends in the bladder. The indication for installation of a stent is the need to ensure the outflow of urine when the urinary tract is blocked. The stent is removed immediately after the cause of the blockage is eliminated
Nephrostomia.
This intervention involves a whole range of surgical techniques. The procedure is temporary and precedes a full-fledged surgical operation to eliminate hydronephrosis. When intervening in the area of the renal pelvis, drainage is inserted in the form of a catheter. The outer end of the catheter is connected to a urinal

Important! Both of these measures are temporary. They only ensure normal urine flow, but do not cope with the cause of hydronephrosis.

The pathology is eliminated exclusively by surgery.

Operations are performed to ensure normal urine flow and kidney function.

Today can be held:

Laparoscopic interventions
Manipulations using the da Vinci robot

Experienced doctors who know modern working methods try to carry out interventions using minimally invasive methods. This allows you to reduce the risks of various complications and shorten the patient’s rehabilitation period. Particular attention is paid to organ-preserving technologies.

Interventions are aimed at plastic surgery of the pelvis or ureter, removal of tumors, crushing stones or removing them from organs and cavities. If during the examination it is determined that the functioning of the kidney is partially or completely impaired, operations may be performed to remove it.

Important! Even after removal of the kidney, the patient can return to his normal life (with some restrictions in physical activity and nutrition).

Before starting treatment for kidney hydronephrosis in adults and children, an examination is carried out to assess the cause of symptoms, determine the degree of damage and other features of the course of the disease.

Hydronephrosis

Already in the womb, the fetus is diagnosed by ultrasound with an abnormal expansion of the renal cavity and pelvic system. Congenital hydronephrosis becomes a consequence of obstructed urine outflow; over time, it will lead to even greater complications - urolithiasis, hypertension, pyelonephritis, renal failure. Pathology occurs at the genetic level and is a consequence of abnormal intrauterine development. Hydronephrosis may be asymptomatic, or it may make itself felt by pain and bloating in the abdomen, regurgitation, blood in the urine, poor appetite and weight gain, dyspepsia, lethargy and moodiness. At the slightest suspicion of a disease, you should immediately contact a pediatric urologist, who will prescribe the necessary list of laboratory tests, make a diagnosis and prescribe treatment.

Advantages of contacting MEDSI

Experienced specialists.
Our doctors have all the skills and knowledge to treat renal hydronephrosis in adults and children. Specialists work in accordance with international standards and use organ-preserving techniques
Opportunities for comprehensive diagnostics.
Before starting treatment for kidney hydronephrosis in adults and children, an examination is carried out to assess the cause of symptoms, determine the degree of damage and other features of the course of the disease. We have modern expert-class equipment. It allows you to detect pathologies in the early stages
Individual therapy methods.
They are selected in accordance with the results of the patient’s examination, after analyzing laboratory and instrumental data
Gentle methods of surgical treatment.
The therapy uses the capabilities of endoscopy, microsurgery and laparoscopy. If possible, operations are performed through small punctures, including using robotic technologies
Modern hospital.
We have high-tech operating rooms with innovative equipment from leading manufacturers. In hospitals, patients are provided with balanced nutrition and round-the-clock care
Fast recovery after interventions.
Particular attention is paid to the new philosophy of patient management after surgery (fast track), which involves the fastest possible return to active life.
Comfort of visiting clinics.
They are located near the metro. This allows residents of any district of Moscow to visit MEDSI clinics. We made sure there are no queues so you don't have to wait long for an appointment

To undergo treatment for renal hydronephrosis in adults and children in our clinics, call (495) 7-800-500. Our specialist will answer all questions and offer a convenient time for consultation with a doctor. You can also make an appointment through the SmartMed app.

Specialized centers

Standards of the International Association of Urology
High-precision diagnostics using cutting-edge equipment
Modern high-tech operating rooms and hospitals

More details

Pyeelectasia in newborns: what is important to know?

How healthy the baby’s kidneys will be directly depends on his mother, so first of all the mother’s medical history is studied. In young children, dilation of the renal pelvis is most often a temporary phenomenon.

Causes of pyeloectasia in newborns:

Difficult patency in the ureters, as they may be filled with pus or there may be a tumor in them.
Incorrect position of the pyelocaliceal system due to anomaly in development.
The mother's lifestyle does not correspond to the norm, which leads to sad consequences. We are talking about smoking, alcoholism, abuse of junk food, illegal substances, and so on.
Increased pressure in the bladder.
Poorly developed muscles of the body.
The mother's immunity and body were weakened during pregnancy, which increases the risk of dangerous infections leading to various pathologies of the fetus.
The body's predisposition to certain diseases, that is, genetics. It is worth noting the importance of timely treatment of pathologies, which allows us to ensure the correct gene pool for future generations.

There are situations when this pyeloectasia is a temporary phenomenon that goes away on its own and does not pose a threat to the baby, but there are situations when this pathology increases the risk of complications in the child.

The difference between adult and pediatric pyeloectasia is that in children this syndrome goes away during the first year of life due to the mildness of the pathology. Adult pyeelectasis, on the contrary, is a consequence of other kidney pathologies and leads to kidney problems in the future, while constantly progressing and causing complications.