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Hydronephrosis – the disease relating to diseases of kidneys and urinary tract, characterized by defeat of renal fabric and deterioration in work of body. Urine outflow disturbance which leads to increase of hydrostatic pressure and expansion in pyelocaliceal system is the cornerstone of a disease.
Work of tissues of kidney consists in formation of urine which comes to a cup lokhannuyu system. After accumulation urine comes to an ureter and further to a bladder. At a hydronephrosis this conductivity is broken, and urine collects much more norm, at the same time the parenchyma (kidney tissue) continues the function, giving urine in crowded cup lokhannuyu system.
The disease can be inborn, congenital anomalies of urinary tract – full and partial obstruction are its reasons. The illness develops owing to congenital anomaly of an arrangement of a renal artery. Incorrectly located it squeezes an ureter. Also inborn narrowings of an ureter, its wrong arrangement, inborn valves are observed. In these cases surgical treatment of a hydronephrosis is without fail carried out.
The acquired hydronephrosis is formed as complication of some urological diseases. Impassability of an ureter can be is caused by a nephrolithiasis, tumors of urinary tract, inflammatory processes of urinogenital system. The contribution to development of a disease is made also by tumors of a prostate and a neck of uterus. Cases owing to injuries are often observed.
The disease symptomatology very scanty, actually is not present signs characteristic only for a hydronephrosis. In certain cases it develops asymptomatically and it is found at diagnosis of other diseases. The aching pains in a waist are characteristic of a disease, at early stages of development of a hydronephrosis of pain are shown in the form of attacks. These symptoms of a hydronephrosis are shown irrespective of activity of the patient, his situation, time of day.
Indirect symptoms are nausea, vomiting, abdominal distention, increase of arterial pressure during pain attacks. Temperature increase happens less often and is connected with existence of an infection which caused a disease. Diagnosis of a hydronephrosis by method of a palpation allocates such important symptom as the tumorous education which is localized in hypochondrium.
In certain cases hydronephrosis symptoms at initial stages are shown only by availability of blood in urine. At 20% of patients its existence is defined visually, in other cases laboratory research is required.
Diagnosis of a hydronephrosis
The disease mainly occurs at women of 25-35 years, more often it is found at suspicions on gynecologic diseases.
Diagnosis of a hydronephrosis consists in full laboratory inspection at which the diagnosis is confirmed, the reason and a stage of an illness is established. Blood tests and urine, ultrasonic inspection of kidneys are appointed. It gives the chance to find availability of blood in urine, extent of expansion cup lokhannoy systems, presence of inflammatory process.
Radiological inspection of kidneys, for size discrimination of body, existence of stones is appointed. A series intravenous Urogramum is carried out. At such inspection enter contrast medium which is processed by kidneys and is removed together with urine into a vein. Thus, it is possible to track work of an urinary system. In hard cases solution is removed within several hours, or not removed at all. Definition of extent of defeat of tissues of kidney appoint radio isotope research, an angiography, a computer and magnetic resonance tomography, scanning of kidneys.
Complications of a hydronephrosis
Increase of hydrostatic pressure in pyelocaliceal system leads to such dangerous complication as a rupture of a cup or a pelvis. At the same time urine comes to retroperitoneal space, breaking work of other bodies.
Also development of a renal failure is characteristic of a hydronephrosis. The kidney stops functioning owing to what the content of residual nitrogen in blood increases. As excess of nitrogen is not removed with urine, there comes intoxication and without timely intervention death of the patient.
Treatment of a hydronephrosis
Treatment of an illness is directed to elimination of the reasons, stops hydronephrosis symptoms, and also is urged to reduce the sizes of a pelvis and to keep a kidney. Preservation of operability of body is also a priority, but as the majority of cases are found at late stages it not always perhaps.
Conservative treatment of a hydronephrosis is appointed only for elimination of inflammatory process, relief of symptoms, lowering of arterial pressure. As a rule, it is appointed in quality of training to an operative measure.
Operational treatment is carried out by several methods which are directed to preservation of body. Such reconstructive surgical interventions help to remove a cause of illness and to keep a kidney and its functions. At late stages of an illness, and especially elderly patients can have a dangerous preservation of body. Complications of a hydronephrosis or full disturbance of work of a kidney its recovery provides impossibility, in that case carry out removal of body.