The reason for the enlargement of the renal pelvis. The renal pelvis is dilated in an adult: what is it?

Causes and classification of pyeloectasiaSymptoms and complications of an enlarged renal pelvisDiagnosis and treatment of pyeloectasia

The renal pelvis is a container that collects urine and then passes it into the ureters and bladder. If there are pathological obstacles to the movement of urine, it accumulates, which can cause the renal pelvis to become enlarged. This disease is called pyelectasis. It can be diagnosed not only in adults, but also in children.

Causes and classification of pyelectasis

An enlarged pelvis occurs due to a violation of the outflow of urine into the ureter. In a child, the pathology may be caused by congenital abnormalities of the urinary system. Direct causes include kinking of the ureter due to abnormal placement of the kidney or a decrease in its lumen. To detect pyeloectasia of the left or right kidney in the fetus, an ultrasound is performed at 15-19 weeks of development.

In an adult, an enlarged pelvis usually occurs due to urolithiasis, when a stone enters the pelvic region or ureter. Also, pyeloectasia can be a consequence of a tumor formation, when it puts pressure on the ureter, blocking it.

Depending on the extent of the lesion, unilateral or bilateral pyelectasis is distinguished. However, the left kidney is less susceptible to this disease than the right, which is due to the peculiarities of its structure. Enlargement of the renal pelvis is also classified according to the severity of the disease. According to this principle, the disease can occur in mild, moderate and severe forms. The severity of the pathology is determined by the ability of the kidneys to perform their functions.

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Symptoms and complications of an enlarged renal pelvis

Typically, pyeloectasia in children and adults is completely asymptomatic. The patient can only be disturbed by the symptoms of the underlying disease, which leads to dilation of the renal pelvis. Stagnation of urine that occurs during illness sometimes causes tissue atrophy, the development of sclerosis and renal failure, which in the absence of qualified treatment can lead to death.

Enlargement of the renal pelvis may be accompanied by the following diseases:

ectopia, in which in boys the ureter flows into the urethra, and in girls into the vagina; megaureter (significant increase in the size of the urinary duct); Vesicoureteral reflux is a process in which urine from the bladder flows back into the kidney.

Due to the occurrence of inflammatory processes, a patient whose renal pelvis is dilated may also suffer from pyelonephritis and cystitis.

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Diagnosis and treatment of pyelectasis

For pelvis sizes up to 7 mm, periodic examinations of the kidneys and bladder are carried out, which must be done every 2-4 months. Ultrasound examinations for children are prescribed once every 6 months.

As the disease progresses, the doctor may prescribe cystography, urography, or an X-ray examination, in which a special contrast agent is injected into the bladder.

Treatment of an enlarged pelvis is mainly aimed at eliminating the root cause of the disease.

Congenital pathologies are treated with surgery. When the excretory duct is narrowed, stenting is used, that is, the introduction of special frames into the narrowed areas of the duct.

If pyeloectasia occurs due to urolithiasis, then treatment is based on removing stones from the kidneys. In this case, both conservative and surgical treatment methods can be used. Urologists often prescribe various physiotherapeutic procedures. In some cases, herbal treatment helps.

To prevent the occurrence of enlargement of the renal pelvis, there are various measures: timely and high-quality treatment of diseases of the urinary system, limiting fluid intake and following other recommendations of the attending physician, which can be prescribed on an individual basis.

Pathological manifestations

If we talk about what anomalies the renal pelvis may have, it is worth noting that they are so connected with the ureter that if anomalies arise in the pelvis, then they also affect the ureter.

There is such an anomaly as doubling of the pyelocaliceal system; it can be complete or incomplete. Complete duplication involves the formation of two renal pelvises, which have separate ureters. With incomplete doubling, the ureters merge at a certain segment and they already flow into the bladder as one channel.

There are many variants of this anomaly, it can be one- or two-sided, the connection of the ureters can occur at different levels. Sometimes there are three or even more ureters, but in most cases, people who have this anomaly may not even know about its existence and live a normal life.

If during the examination you were diagnosed with such an anomaly, and it does not bother you, then there is no need to worry, it does not require any treatment.

If the renal pelvis is dilated, then there is an increase in the volume of the pyelocaliceal system, and the reasons may be different. This anomaly can be congenital or acquired; in medicine it is called hydronephrosis.

Diagnostic measures

Before you begin to treat this pathology, it is necessary to eliminate the reasons that led to its development. If these are congenital factors, then surgery is required to eliminate them. If the patient has a narrowed ureter, then a special device is inserted into the narrowed area, which allows it to be expanded to the desired size.

If pyeloectasia is congenital, then in 70% of all cases, it usually resolves on its own before the age of one year. About 25% of the remaining cases are treated with medication, only 5% of cases require surgery.

If in adults the enlargement of the pelvis occurs due to the presence of stones, then the doctor will select a treatment that helps get rid of them, this can be done with the help of drugs or during surgery.

It is necessary to stop the inflammatory processes that allow pathogenic microorganisms to enter the urine; in such cases, there is no need to drink a lot of fluids or use diuretics.

In adult patients with pyeloetasia, surgery is required in 20-40% of all cases. During the operation, an obstruction that interferes with the normal flow of urine is removed. Often such operations are performed without open intervention through endoscopy.

If no measures are taken, the difficulty of passing urine may increase, which leads to a significant deterioration in kidney function. This can provoke an inflammatory process in the kidney, and then its sclerosis. Enlargement of the renal pelvis is not an independent disease; it is caused by pre-existing disturbances in the functioning of the genitourinary system.

Hydronephrosis of the kidney

If during pregnancy a woman had abnormalities in the development of the fetus, this can lead to abnormalities in the development of the kidneys, for example to the development of congenital hydronephrosis of the kidneys. This happens due to the fact that urine cannot leave the pelvis normally, which leads to its expansion. In addition to the expansion of the renal pelvis, the same happens to the calyces, as a result of which disturbances in the functioning of the kidneys develop.

In order to conduct an ultrasound examination of the fetal kidneys, the fetus must be 20 weeks old. This makes it possible to measure the size of the kidneys, look at their structure, and evaluate the pelvis and ureter. This diagnosis is made in approximately 1.4-1.5% of the infants examined. Among kidney pathologies, this anomaly accounts for half of all cases.

The reason that a child has congenital hydronephrosis is mainly due to a narrowing of the place where the pelvis connects to the ureter. In addition, reverse flow of urine into the kidney may occur. This is due to the fact that the orifice of the ureter, which acts as a valve, has a dysfunction.

In such cases, treatment begins after the baby is born. Only in very extreme cases does the surgeon decide to perform an intervention during pregnancy.

In adults, hydronephrosis usually develops because the normal flow of urine is impeded by narrowing of the ureteropelvic segment. In addition to the fact that this anomaly in adults can be congenital, it can also be acquired, and its cause may be the presence of a stone.

There are a number of other reasons that can lead to the development of this pathology. To eliminate it, there are several surgical treatment methods, but recently low-traumatic methods such as laparoscopy and endoscopy have become popular.

Symptoms of renal pelvis cancer and treatment measures

Renal pelvis cancer is less common than kidney or bladder cancer, but it requires special attention. One of the main symptoms that may indicate the development of cancer is the appearance of blood in the urine. Another symptom is lower back pain, which occurs due to blockage in the urinary system. This may be due to a blood clot or due to the development of a tumor. In addition, the person begins to lose weight sharply, he often feels sick and vomits.

If the doctor suspects the development of a tumor, he palpates the abdominal cavity, which allows him to identify a large tumor. Blood and urine tests are required, as well as an ultrasound examination of the said organ.

If an ultrasound shows that there is a tumor of the pelvis, the doctor prescribes a computed tomography scan, which allows a more accurate diagnosis, to determine at what stage of development the tumor is and whether it is possible to remove it.

In cases where the tumor is concentrated only in the pelvis or ureter and there are no metastases, it can be removed through surgery. This usually involves removing the entire kidney, ureter, and some of the bladder. There are cases, for example, if there is only one kidney, then only the tumor is removed, and healthy tissue remains. But this method of treatment is associated with the risk of relapse. If surgical treatment is not possible, chemotherapy is prescribed.

In any case, if you have an enlarged renal pelvis or other abnormalities, you should definitely consult a doctor who will prescribe all the necessary tests and examinations. Based on the results obtained, he will be able to make the correct diagnosis and prescribe effective treatment. The sooner this is done, the greater the chance that you will completely get rid of this disease.

In the human kidneys there are so-called pelvises. They are special containers that hold urine before it passes into the ureter. In a normal healthy state, the size of the pelvis can vary depending on human parameters: height, weight, general physique. However, if the doctor discovers that the patient’s renal pelvis is dilated and it has been in this state relatively recently, then he diagnoses pyelectasis. More advanced stages represent serious abnormalities and pathologies.

It should be noted that the pelvis is part of a single pyelocaliceal system, which is responsible for the accumulation and subsequent transportation of urine. The fact is that the calyx and pelvis are connected by a very narrow passage called the neck. By its nature, it is very small in diameter, so the slightest blockage can lead to expansion of the renal pelvis.

Basic prerequisites for pelvis enlargement

Most often, this disease occurs as a congenital disease, but it can also be acquired during life. In general, an enlargement of the renal pelvis is a sign of improper outflow of urine, which, in turn, is the root cause of the deviation. But it is worth considering specific factors predisposing to the development of the disease:

kidney stones;
bladder fullness;
formation of tumors in the organs of the excretory system;
narrowing of the urinary tract due to injury;
disturbances of normal urinary outflow, in particular, its weakening due to an enlarged pelvis;
inflammatory processes occurring in the urinary system;
increase in intrarenal pressure.

Genetics also plays an important role. If there were or are people in your family suffering from kidney diseases, then there is a high probability that a hereditary factor will work. Therefore, it is always important to protect the health of your loved ones, and if necessary, send them for examination.

If you do not want your children - the future generation - to be susceptible to urolithiasis, then start taking care of yourself first, consult a doctor and do not delay treatment.

And all of the above reasons are associated primarily with other diseases of the human excretory system. In addition, some patients have anatomical abnormalities, resulting in abnormal organ structure. They also cause dilation of the pelvis, so it is recommended to undergo a hospital examination on a regular basis at least once a year.

Kidney diseases are the root cause of dilated pelvis

Symptoms and diagnosis of pyelectasis

It is quite difficult to identify kidney diseases on your own, for this reason they can go undetected for a long time. To understand that the pelvis is enlarged, you need to know the corresponding signs that the patient can observe. It is worth noting that the course of the disease and, in general, are somewhat different from what adults observe. Therefore, here we will look at the main signs and symptoms that occur when the renal pelvis enlarges in an adult (but remember that pyeelectasis is not the main disease, but occurs as a complication):

Pain in the lumbar area. Although they can be caused by other abnormalities, it is important to consider their severity.
Poor urine flow is unpleasant urination associated with urine retention, but at the same time you often want to go to the toilet.
The occurrence or presence of all kinds of infections, and they can also manifest themselves in their own way.

Such a small number of signs that the renal pelvis is enlarged suggests that this phenomenon is practically asymptomatic. However, everyone should have basic ideas and knowledge. Now the only question is the correct diagnosis.

Urography is a necessary and useful method for examining the organs of the excretory system.

The most accurate result is provided by ultrasound examination. And usually, dilation of the renal pelvis is an extremely unexpected diagnosis for the patient. Therefore, after an ultrasound, the doctor prescribes further examination to help determine the overall condition of the human body. This may include:

General urine analysis. It is necessary to identify all possible concomitant diseases and infections.
Cystography. Shows the condition of the bladder: a bright substance is injected into it, after which an x-ray is taken
Urography. In this method, a dye is also injected, which passes through the kidneys and is then excreted through the excretory organs.

All this helps to most accurately determine the state of the human excretory system and, therefore, prescribe the appropriate course of treatment.

Prevention measures

To avoid such a disease as an enlarged renal pelvis, you should follow some recommendations. To begin with, remember that under no circumstances should you endure or put off going to the toilet for a long time. This can have a negative impact on your entire urinary system.

To prevent further development of an enlarged pelvis, it is important to maintain normal blood circulation and stimulate the flow of urine

After several hours of sedentary work, it is simply necessary to do at least a small warm-up. Firstly, it will improve blood circulation, and secondly, it will prevent stagnation of urine and normalize its outflow. In general, especially people in adulthood whose renal pelvis is dilated, need to exercise more often, since many lead a completely inactive lifestyle.

In addition, you can strengthen your immunity with various vitamins, and some prefer traditional medicine. This is not bad if the use of tinctures and decoctions does not go beyond the normal, and they, in turn, consist of truly useful components.

Remember! Under no circumstances should you self-medicate, as it will do more harm than good. Take vitamins and eat right, but do not overdo it with folk remedies.

Treatment methods for enlarged pelvis

Initially, doctors are struggling with the reasons for the expansion of the collecting system, since it is at this stage that the disease can be most safely eradicated, as well as possible complications and pathologies can be prevented. Based on the results of the examinations and from his professional point of view, the doctor decides whether conservative treatment is applicable in this case, and whether the patient needs surgical intervention.

Almost every patient has to start by taking medications that can stop the inflammatory processes occurring in the CLS. In addition, patients are forced to follow a simple diet. It is important to drink less liquids, but not to reach an extreme state, otherwise the body will simply become dehydrated. It is also necessary to give up diuretics, which, by the way, includes coffee.

Current surgical intervention provides painless treatment for patients

Next, the doctor looks at the stability of the person’s condition, and again a picture of the renal pelvis is taken. He can prescribe a course of drugs sold strictly according to the prescription, or announce to his patient about the upcoming operation. But there is no need to be afraid of this, since modern technologies make it possible not to perform open operations, intervening in the dilated pelvis of the kidney in an adult only through the urethra.

This operation allows you to improve the flow of urine by correcting the position of the cervix. After successful completion of the procedure, the patient can be prescribed medications aimed at restoring the body and immunity as a whole.

Special cases of the disease

The consequences of kidney disease during pregnancy should be considered, since this topic is especially exciting for expectant mothers. Moreover, they cause discomfort, which creates an additional reason for stress for a woman. There are two types of occurrence of this disease:

Before pregnancy	During pregnancy
In this case, doctors order a full examination and leave the woman under constant medical supervision, since the stage of the disease could have moved forward long ago, and the consequences could be irreversible for both the pregnant woman and the unborn baby. In extreme cases, a decision may be made to terminate the pregnancy.	Here, special importance is attached to the presence of infections in the body, which can be treated. The pregnant woman is prescribed complete rest and the necessary medications are prescribed, which indicates the possibility of conservative treatment. The main thing is to prevent the disease from becoming acute, otherwise the outcome will not be happy at all.

During such a period, the expectant mother simply needs the care of loved ones. Especially considering the fact that physiological and mental health are closely interconnected. Timely visit to the hospital can prevent the worst consequences, so never delay going to the doctor. Firstly, his consultation will help you monitor your health, and secondly, you will protect not only yourself, but also your loved ones, in particular, children.

The kidneys are a paired organ with a complex structure that performs the functions of creating, storing and removing urine from the body. The pyelocaliceal system (PSS) plays an important role in its functioning: it collects urine formed in the nephrons and further evacuates it through the ureters into the bladder. There are several dozen diseases that occur with damage to the calyces and pelvis, and pyeloectasia of the kidneys is one of them.

It is known that the normal size of the renal pelvis is 3-6 mm in children and adolescents and 10 mm in persons over 18 years of age. Pyeelectasis is a pathological expansion of the renal pelvis in adults and children. According to statistics, this syndrome is more typical for the stronger half of humanity. Due to the anatomical features of the urinary organs, pyeelectasis of the right kidney develops several times more often than the left.

Causes and mechanism of development

Pyeelectasis is not considered in medicine as an independent disease. This condition is only a syndrome, and is characteristic of many pathologies of the urinary organs. Enlargement (ectasia) of the renal pelvis can be caused by:

Congenital malformations

horseshoe kidney;
ureteral strictures;
dystopia of the ureter;
ureteral agenesis;

Acquired diseases

urolithiasis;
benign/malignant tumors of the urinary organs;
back and abdominal injuries;
chronic inflammation of the kidneys – pyelonephritis, glomerulonephritis;
prostate adenoma.

Pyeloectasia of the kidneys often develops during pregnancy. Expectant mothers more often encounter right-sided damage to the urinary organs: this is due to the deviation of the growing uterus to the right. Unlike pathology, expansion of the maxillofacial area in pregnant women, even up to 25-27 mm, as a rule, does not require treatment and goes away on its own after childbirth.

The pathogenesis of the disease is based on a violation of the physiological outflow of urine from the renal pelvis to the ureter, bladder and urethra. The accumulating fluid gradually causes dilatation and expansion of the renal collecting system. This, in turn, leads to compression of the parenchymal structure, nephron atrophy and the development of progressive renal failure.

Classification

Depending on the extent of damage to the organs of the urinary system, two forms of pathology are distinguished:

unilateral pyeelectasis of the left or right kidney;
bilateral pyelectasia - of both kidneys.

The syndrome is also classified according to severity (mild, moderate, severe). In this case, one should take into account not only the severity of the pathological process, but also the volume of remaining functionally active tissue, the presence of a concomitant inflammatory process, and signs of renal failure.

Symptoms typical of pyelectasis

The clinical picture of pyelectasis is nonspecific and largely reflects the disease that caused it:

Urolithiasis is manifested by periodic intense pain in the lower back (renal colic).
With kidney tumors, patients complain of aching pain in the back, radiating to the groin and abdomen. Sometimes it is possible to excrete red blood in the urine.
If the renal pelvis is dilated due to chronic inflammation, signs of intoxication, lower back pain, cloudiness of urine, the appearance of sediment and mucus in it come to the fore.

Often the pathology is asymptomatic for a long time and becomes an accidental finding on ultrasound. Infection of the dilated collecting apparatus leads to the following symptoms:

fever up to 38.5-41 ° C;
chills;
dizziness;
nausea, vomiting that does not bring relief;
loss of appetite;
decreased performance.

Diagnostic measures

Before starting treatment for the pathology, it is necessary to establish the main cause of the expansion of the heart rate. A standard diagnostic plan for kidney disease includes:

Collection of complaints and medical history. It is important for the doctor to outline the boundaries of possible problems and make a preliminary diagnosis.
Inspection, palpation, percussion, determination of the tingling symptom. Allows you to diagnose enlarged kidneys, the presence of an inflammatory process or stones in them.
Blood tests (general, biochemical). With their help, you can learn about existing health problems and possible somatic pathologies.
Urine tests (general, according to Nechiporenko, according to Zimnitsky).
Instrumental diagnostic methods - ultrasound, CT, MRI, excretory urography.

Instrumental tests are the main method for detecting pyelectasis. If the renal pelvis is dilated, this can be easily determined, as well as the exact size of the organ can be determined using visual diagnostic methods.

Principles of therapy

Treatment of pyeelectasis, like most pathologies, requires an individual approach. The doctor must take into account the cause of the disturbance in the outflow of urine, the age of the patient, concomitant diseases and injuries, and the degree of disruption of the functioning of the nephrons. Therapy can be carried out both conservatively and surgically.

Conservative (medicinal) treatment consists of prescribing antibacterial, anti-inflammatory, antispasmodic and uroseptic agents. The average duration of their use is 10-14 days.

But still, most conditions accompanied by pyeelectasis require surgical treatment. Using safe and effective techniques, the disease is eliminated (for example, widening the lumen of the ureters, removing stones). The impaired outflow of urine is restored quickly and painlessly. In the future, the patient needs regular examinations by a therapist and prevention of possible complications.

If you have an enlarged renal pelvis, consult your doctor immediately. Timely diagnosis and treatment of pathology will allow you to restore impaired functions of the urinary organs and prevent the development of complications. And kidney health, in turn, is important for the smooth and coordinated functioning of the body.

A disease in which the renal pelvis is dilated is called pyeloectasia. This is a very common anomaly that is found in the urinary system. Enlargement of the renal pelvis is often diagnosed before the birth of the child, during pregnancy or in the first year of the baby’s life. Therefore, pathology can be safely attributed to congenital structural features of the body.
However, a disease in which the child is enlarged may appear at a later time. So, at the age of 6-7 years, intensive human growth begins and changes relative to each other. As a result, compression of the ureter by an additional or abnormally located vessel may occur. In an adult, dilatation of the pelvis can occur due to blocking of the lumen of the ureter by a stone.
Pyeelectasis can develop when there are obstructions or difficulties in the flow of urine at various stages of its excretion. These problems may be associated with developmental abnormalities, kinks, narrowing, compression of the ureter, or temporary or permanent refilling of the bladder with fluid. If it is constantly overfilled, then the child urinates rarely and in large quantities. Also, the reasons may be obstacles that prevent the passage of fluid from the ureter into blockage with stones, clots of pus (usually in adults).
With the correct diagnosis and adequate treatment, the disease in which the renal pelvis is dilated is curable. In some cases, the child recovers independently, associated with growth and changes in the relative position of organs, as well as with the redistribution of pressure in the urinary system in the required direction. In addition, pyelectasis may cease as a result of maturation of the child’s muscular system.
Due to the fact that after birth the most intense growth occurs, during which organs quickly develop and change their relative positions, the functional load on systems and organs increases, and at this time most developmental defects appear, including the urinary system. Growth that is not as intense, but very significant for the occurrence of developmental anomalies, occurs during the period of elongation and adolescence. Therefore, if the renal pelvis is dilated in the fetus or in a child in the first months of life, then pyeloectasia will definitely have to be monitored during the first year and in other critical periods.
Consequences
If so, this is primarily due to an increase in pressure in the organ, which affects the adjacent kidney tissue. Over time, part of the kidney tissue is damaged by constant pressure, which leads to disruption of normal functioning. In addition, additional efforts are required to remove urine, which distracts it from normal work.

There is no universal way to treat pyeelectasis; it all depends on the suspected or established cause. Thus, if there is a sharp increase in the size of the pelvis or if there are abnormalities of the ureter, the child may require surgical intervention aimed at removing obstacles to the outflow of urine. Sometimes incorrect wait-and-see tactics can lead to kidney loss.
If the renal pelvis is dilated, but there are no visible sharp deteriorations (according to urine tests, ultrasound results), another tactic can be used, which consists of observation and conservative treatment. Doctors prescribe herbal medications, physiotherapeutic procedures, and control ultrasound.

New imaging techniques have expanded clinicians' ability to diagnose urinary tract diseases. This revolution began with the everyday use of ultrasound, and then came computed tomography and magnetic resonance imaging.

This made it possible to detect new kidney changes that are symptoms of certain diseases. Today we will look at why the renal pelvis is enlarged, what pathologies this is typical for, and also what clinical signs it manifests.

What is the renal pelvis: structure and functions

The renal pelvis is the anatomical structure of the organ where the primary accumulation of urine occurs before its further entry into the ureter. They enter the pelvis through the constrictions (necks) of the calyx. This is where urine comes out after passing through the glomerular and loop systems of the kidneys.

The walls of the pelvis consist of several layers: epithelium, connective tissue and smooth muscle fibers. They provide a seal and also play an important role in maintaining the integrity of its form.

Formally, the pelvis is a storage cavity. It collects urine from various parts of the kidney and sends it along a gradient of hydrostatic pressure into the ureter. Liquid should not normally remain in it for a long time.

Signs of enlarged renal pelvis

Enlarged renal pelvis in adults (pyelectasia) is a pathological condition in which its cavity expands. Depending on the location, it is divided into one- and two-sided, and depending on its severity, it is divided into 4 degrees.

Clinically, an enlarged renal pelvis rarely appears on ultrasound, especially if it is a congenital feature. The symptoms of diseases that led to this pathology or are its complications come to the fore:

The enlargement of the renal pelvis itself is a condition that must be confirmed by imaging methods (ultrasound, CT or MRI).

Causes and mechanism of development of pathology

The pathogenesis of the development of pelvic enlargement has been studied in sufficient detail. This is what made it possible to use the presence of this symptom to diagnose certain diseases.

Chronic pyelonephritis is in first place in terms of the frequency of causes of enlargement. If an isolated lesion of the pelvis occurs, this condition is called pyelitis. The most common pathogenic pathogens that cause the disease are Escherichia coli, staphylococci, streptococci, Proteus, and enterococci. As the disease becomes chronic, degenerative processes occur in the wall of the pelvis (associated with the proliferation of connective tissue), which gradually leads to its deformation and expansion.

The second mechanism occurs in urolithiasis. With this pathology, stones form in the lumen of the pelvis, the size of which gradually increases over time. They can enter the ureter and block its lumen. Clinically, this will manifest as renal colic. Physiologically, there is an increase in hydrostatic pressure inside the pelvis, as urine continues to flow, and its outflow is difficult. There is an increase in pressure on the walls, and if it exceeds certain values, or attacks of ureteral obstruction occur too often, then dilatation develops.

Also, with urolithiasis, a stone may form in the lumen of the pelvis, large enough to no longer pass through the ureter. If it is not surgically removed in a timely manner, then after a certain period of time (5-15 years) a coral-shaped formation may form, which will completely fill the free cavity of the pelvis and will put pressure on the wall, which will lead to expansion.

Enlargement of the pelvis can also occur with malignant kidney tumors. The tumor can grow into the walls of the pelvis or ureter, which leads to disruption of the outflow of urine and a decrease in the elastic resistance of the walls.

Congenital anomalies of the development of the pelvis are slightly less common. They are often combined with abnormalities in the development of connective tissue or kidney defects. These anomalies are in most cases asymptomatic and are discovered accidentally during an ultrasound examination.

Depending on the mechanism of development, enlargement of the renal pelvis is usually divided into three groups:

Ultrasound diagnostics of pathology

Ultrasound examination of the kidneys is a routine examination method for diseases of the genitourinary system. The doctor usually diagnoses it after examining the patient and passing laboratory tests. Usually, a bladder examination is carried out together with the kidneys, so before the examination you need to drink 1.5 liters of still mineral water. This allows the urinary system to be filled with urine, which increases the information content of the study.

Ultrasound examination of the renal pelvis can be performed both on an outpatient and inpatient basis. It is carried out in a specially equipped room. The patient arrives at the appointed time, takes off his outer clothing and lies down on his side. A special gel is applied to the skin, which increases the permeability of the skin to ultrasonic waves. Then a special sensor is placed on it at a certain angle.

During the examination, the doctor must pay attention to the condition of the kidney parenchyma, the presence of connective tissue proliferation, benign or malignant neoplasms. It is also necessary to measure each of the kidneys. The doctor then focuses on the condition of the pelvis. When examining them, he examines:

dimensions (longitudinal, transverse) of the cavity of the pelvis;
the presence of stones in the pelvis (well visualized by ultrasound);
wall thickness, presence of growths, deformations;
functional state of the pelvis.

The detected results are recorded in the ultrasound findings. After the kidneys, they usually move on to examining the ureters and bladder.

The results are delivered to the patient or the attending physician (can be sent by email).

Standard indicators

The normal size of the renal pelvis in adults and children depends on the age of the patient:

1-6 years – up to 5-6 mm;
7-12 years – up to 7-8 mm;
13-18 years – up to 9-10 mm;
in adult patients – up to 11 mm.

Useful video

What symptoms may indicate a malfunction of the organ can be found in this video.

At the same time, some pregnant women experience the development of physiological dilatation of the pelvis up to 24-25 mm (especially with multiple pregnancies). This is due to the body's adaptive mechanisms and is a temporary condition. After childbirth, a reverse decrease in the size of the cavity occurs within a few weeks.

In addition, the surface of the pelvis should be smooth, without growths, deformations or thinning of the wall. There should be no blood clots or stones in its cavity. The flow of urine should occur without difficulty.

Further management of the patient

The detected enlarged renal pelvis requires dynamic monitoring. If the cause of its development is another disease (pyelonephritis, urolithiasis, cancer), then it is necessary to focus on its treatment. Usually, effective therapy (the use of antibiotics, uroseptics, lithotripsy) allows one to stabilize the size of the pelvis and achieve partial regression.

Surgical treatment is indicated if congenital pyelectasia is detected in a newborn, grade 3 dilatation (hydronephrosis), development of a staghorn stone, or complete obstruction of the ureter. Most modern intervention techniques are laparoscopic, which has made it possible to perform pelvisplasty with a much lower incidence of complications.

After surgery, patients are recommended to undergo regular ultrasound diagnostics of the urinary system (once a year). This makes it possible to prevent the re-development of pyelectasis, which occurs in approximately 5-7% of patients.