Hydronephrosis

Hydronephrosis from the Greek language means "water in the kidneys' hydronephrosis is a common congenital disease or a condition that occurs in about 1 in 500 babies, however, hydronephrosis can also appear later in life for both children and adults hydronephrosis -... Disease in which the flow of urine in the bladder is slower than it should be, and as a result, this leads to the fact that the urine accumulate in the renal pelvis in more canadian pharmacy drugstore than they should and thus disrupts the normal kidney work. hydronephrosis can affect one kidney (unilateral) or both kidneys (bilateral). hydronephrosis is "prenatal" or "prenatal", as well as postnatal. The term "prenatal" or "prenatal" means that hydronephrosis was found in a child before birth. postnatal means that hydronephrosis was detected after birth .

Obstruction or blockage is the most common cause of hydronephrosis. This may be due to problems that occur during pregnancy, the fetus (prenatal) or may be a physiological response to pregnancy. Approximately 80% of pregnant women develop hydronephrosis or hydroureter. According to experts, it appears, in particular, because of the effects of progesterone on the ureters, which in turn reduces their tone.

Nowadays hydronephrosis usually initially diagnosed on prenatal ultrasound. Detection of hydronephrosis while the child is in the womb, has become more common due to the high achievements in the field of prenatal ultrasound. Prior to the development of this technology, children born with hydronephrosis, it was impossible to make an accurate diagnosis so long until they began to show symptoms of kidney disease, as well as often hydronephrosis could be never revealed. Many children with the diagnosis of prenatal hydronephrosis, have the capacity to self-recovery at a very early age, without medical intervention.

Causes of hydronephrosis in children

A number of conditions can lead to hydronephrosis. Experts in the field of pediatric urology work individually with each patient, identifying the cause of hydronephrosis in each child, to then create an individual treatment plan. In some children, the root causes of hydronephrosis can not be established.

While there are many conditions that lead to hydronephrosis, are the most common causes of obstruction (clogging), which reduce the ability to pass urine from the kidney to the bladder. These obstructions can include:

Obstruction of UPJ - a blockage or blockage at the point where the kidney meets the ureter (the tube through which urine is transferred to the bladder).

Ureteral obstruction, cystic segment - a blockage or obstruction at the point where the ureter meets and is connected to the bladder.

Posterior urethral valve - a congenital condition occurring only in boys. It is a pathological tissue in the valves of the urethra (the channel that carries urine from the body to the outside), impeding the free flow of urine from the bladder.

Ureteroceles - occurs when the ureter is not develop properly, and the bladder is formed a small bag.

Treatment of hydronephrosis in children

Most children will have to undergo ultrasound examination about every three months during the first year of life, so that experts could correctly identify the extent and progression of hydronephrosis. Many children with the diagnosis of prenatal hydronephrosis are under careful medical supervision, because their state is able to eventually return to normal on their own without surgery. In most cases of mild and moderate forms of hydronephrosis requires only periodic monitoring.

If hydronephrosis for the child is getting worse over time, or initially was diagnosed with a serious form, medical intervention may be necessary. The operation is usually performed pediatric urologist. The most common procedure carried out for the correction of hydronephrosis is pyeloplasty. Pyeloplasty is to remove narrowed or diseased parts of the obstruction of the ureter and then its re-accession to the healthy part of the drainage system. The success and outcome of pyeloplasty is about 95%. There are instances where there may be other operations are needed.

Fetal surgery

There are rare cases where prenatal hydronephrosis so serious that exposes the fetus lives in danger. Typically, this means that the increased risk of low amounts of amniotic fluid (a condition called oligohydramnios), ureteral blockage child drainage blocking both the bladder and kidneys.

The most reliable surgical intervention in the fetus is a procedure analogous to the procedure of amniocentesis. Guided by ultrasound, surgeons perform a shunt (a small tube) through a large needle inserted through the mother's abdomen directly into the child's increased urinary bladder. The shunt allows the urine accumulated in the bladder to drain into the amniotic cavity.

Even after fetal intervention, after child birth, probably will continue to be necessary for a surgical treatment to provide drainage of the bladder normal and protection of renal function.

Surgery

Typically, surgery is required only in severe hydronephrosis, but sometimes it can be an option for some children with moderate hydronephrosis tezhestyu. The aim of surgery is to reduce swelling in the kidney and the pressure by reducing the free flow of urine.

Speaking about the surgical procedure, often referred pyeloplasty, which eliminates the most common type of lock, causing hydronephrosis in ureterovaginal junction segment. After the operation, the children usually remain in the hospital for about three days and fully recover in about two to three weeks; the success rate is about 95%.