In the article, we will consider what kidney PLS is.
The kidneys have a complex structure, which includes a number of functional units. These include CHLS, that is, the pelvicalyceal system, which is responsible for the collection and excretion of urine formed in the glomeruli. About the structure of the renal cups, their functions in the body, possible diseases and the need for treatment will be discussed below.
Structure of the kidney
Where is the PCS located in the kidney?
Such an organ as the kidney is paired, the shape is bean-shaped, it is located in the space behind the peritoneum. It is covered on the outside with fat cells and perinephric tissue, after - a dense fibrous membrane and parenchyma, that is, a functional tissue in which the liquid blood part is filtered and urine is formed.
From the inside, the surface of the organ is represented by the pyelocaliceal system. 6-12 small cups in the form of a glass are connected with a wide end to a pyramid that secretes urine, and with a narrow end they are connected to each other.another, forming 3-4 large bowls. Such structural elements then pass through the narrow neck into the renal pelvis.
Under the pelvis is understood the cavity into which the urine secreted by the pyramid enters. Then, under the influence of smooth muscle contractions, all the processed fluid goes to the bladder through the ureters and then is completely excreted from the human body.
Functioning of the pelvicalyceal apparatus and possible pathologies
Based on anatomical features, the primary function of the pelvicalyceal system is to collect, store and evacuate urine into the bladder.
ChLS of the kidney is unified and complete, it works smoothly and clearly. In case of violations of the functioning of any of its elements, a person develops disorders of the kidneys in particular and the urinary system as a whole. Therefore, it is very important to know the possible symptoms of a defect in the pelvicalyceal system for timely diagnosis and further treatment.
PCS of the left kidney, as well as the right one, is especially often affected in various diseases. The most probable reasons for its functional and structural changes will be considered below.
Defects from birth
Like any other pathology, kidney disease can be acquired or congenital. Among the latter stand out:
- megaureter - a strong expansion of the ureter, which leads to defects in the excretory function;
- ureter strictures - sudden narrowing or complete occlusion of the lumenureter, which leads to a violation of the outflow of urine;
- congenital ureteral reflux - abnormal backflow of urine into the renal pelvis from the ureter.
Congenital malformations of the organs that excrete urine, most often quickly cause decompensation of the condition and require surgical therapy.
Hydronephrosis
One of the most common disorders of renal PCS is hydronephrosis, caused by a long-term defect in normal urination. The main reasons for this condition are:
- blockage of the ducts of the pelvis or calyx with a stone in ICD;
- strictures that develop as a result of chronic or acute inflammation;
- growth in the lumen of the PCL of volumetric formation - malignant and benign tumors;
- kidney injury.
Violation of the outflow of urine causes an increase in pressure in the cups and pelvis, their dilation, that is, thinning of the surface. Often at the same time CHLS of kidneys is expanded. When the process of pathology spreads to the parenchyma, deformation first occurs, and then complete atrophy of the glomeruli and tubules of the kidneys: the organ ceases to function in the previous mode, and its insufficiency develops.
Typical signs of hydronephrosis are:
- defect of descending urinary current;
- renal colic (sudden intense pain in the lumbar region);
- hematuria, that is, the excretion of blood in the urine caused by damage to the tissue of the kidneys and microtraumas.
With hydronephrosis, conservative treatment is ineffective. Its direction is the relief of pain syndrome, suppression of infection and prevention, pressure reduction, correction of kidney failure in the period before surgery.
In acute hydronephrosis, percutaneous (percutaneous) nephrostomy becomes an emergency method to remove accumulated urine and reduce pressure in the kidney.
Surgical treatments for hydronephrosis can vary and are determined by the cause of the condition. In general, the methods of surgical treatment of hydronephrosis are divided into organ-removal, organ-preserving and reconstructive.
In what other cases is PCLS of the right or left kidney affected?
Pyelonephritis
Pyelonephritis refers to a chronic or acute inflammatory process of the mucous membrane of the pelvis and calyces.
Patients are often interested in what it is - a thickening of the PCS of the kidneys, and what are its symptoms.
Its main manifestations include:
- lumbar pain - sharp, sharp or pulling, aching;
- darkening urine and discomfort during urination;
- signs of intoxication: loss of appetite, fatigue, fever reaching 38-39.5˚, headache.
Typical symptoms of pyelonephritis on ultrasound are inflammatory diffuse changes in the structure of the PCS of both kidneys, induration. The disease is treated with the appointment of a long antibacterial course, antispasmodics, uroseptics. With severe inflammation of the PLS of both kidneys, hospitalization may be necessary. In the future, it is important for all patientsfollow a special diet for the kidneys, lead a he althy lifestyle and not get cold.
Causes and classification of renal pelvis enlargement
Pyeloectasia, or enlargement of the PCS of the kidneys, appears due to violations of the outflow of urine. In young children, pathology occurs due to congenital defects. To determine a congenital anomaly in the mother's womb, a woman is given an ultrasound scan from 15 to 19 weeks of her pregnancy.
In an adult, an enlarged renal pelvis is most often diagnosed with urolithiasis (the ureter is blocked by a stone that enters the pelvis area). In addition, malignant and benign tumors that cover the ureter can cause the expansion of one or two kidneys at once.
At the same time, the left kidney undergoes such a pathology less often than the right one, which is associated with the peculiarities of the structure of the organ. The expansion of the pyelocaliceal system is classified according to the severity of the inflammatory process and the ability of the kidneys to function.
Expansion treatments
Medical specialists first of all eliminate the causes of the expansion of the pelvicalyceal system, since it is at this stage that the patient can be effectively treated and complications avoided. When conducting a set of necessary examinations, the doctor will decide whether to choose a conservative type of treatment, or you can no longer do without surgery.
First, the patient is prescribed medication, as medication can help minimize inflammation. In addition, the patienta special diet is required. If the patient has dilated renal pelvis, he should stop taking diuretics, including coffee. You need to drink fluids in moderation, but it is not recommended to bring the body to dehydration.
After taking the course of medication, the doctor again prescribes an ultrasound examination to the patient. If there is no improvement in the condition, funds can be prescribed that are dispensed in pharmacies exclusively by prescription. In addition, in some cases, surgery may be necessary. However, there is no need to be afraid of the expected operation, since it is carried out through the urination canal, open intervention is avoided.
After some manipulations, the surgeon will adjust the urinary outflow. After the intervention, patients are prescribed drugs that restore the overall immunity of the body.
Doubling the pelvis
Double pelvis of the kidney may not show pain symptoms for a long time.
This is a developmental anomaly in which the pelvicalyceal system is duplicated. Often people do not suspect for a long time that they are sick, because doubling does not appear in any way. However, such a kidney is more susceptible to the occurrence of inflammatory processes. Sometimes the problem leads to a violation of urodynamics and stagnation of urine. Over time, the bacterial flora joins this process and a person develops pain in the lower back and when urinating. Possible fever and swelling, especially of the face in the morning.
Reasons for doubling of kidney PLS
Doubling of the kidneys may appeardue to the influence of harmful factors on a woman during pregnancy, or the reason lies in the defective altered genes of the parents. During the formation of the urinary organs, the impact of adverse factors can cause developmental anomalies:
- insufficient intake of minerals and vitamins;
- ionizing radiation;
- taking certain medications;
- drinking and smoking.
Incomplete doubling
This type of doubling is the most common violation of the formation of the urinary system. Incomplete doubling of both the left kidney and the right kidney is equally common. At the same time, the organ is enlarged in size, the lower and upper sections are clearly distinguished, each of which has its own renal artery. The pelvicalyceal system does not bifurcate with incomplete renal doubling, one kidney functions.
Full doubling
With full doubling, two buds are formed instead of one. Thus, the doubling of the organ on the left differs in that the patient doubles the PLS of the left kidney. But in one of the parts, the pelvis is underdeveloped. A separate ureter emerges from each pelvis, capable of flowing into the bladder at different levels.
Doubling treatment
Kidney doubling therapy is needed when a number of complications appear. When this anomaly does not bother a person, observation is necessary. It is recommended to have a clinical examination of the urine and an ultrasound of the kidneys once a year.
For inflammatory complications, broad-spectrum antibiotics are prescribed.
With such a disease oftenstones can form that cause renal colic. In this case, herbal remedies (corn silk, kidney tea), analgesics and antispasmodics are usually prescribed.
Surgical intervention is needed for severe hydronephrosis or for diseases that cannot be treated with medication. Surgeons strive to preserve the organ. Complete removal is performed only when the kidney is not functioning. If organ failure develops, hemodialysis and organ transplant are prescribed.
