The Nephroptosis: symptoms, treatment of nephroptosis of the right (left) kidney
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Nephroptosis Nephroptosis is a condition characterized by pathological increased mobility of the kidney. Normal is the organ's vertical mobility within 1-2 cm. With the development of nephroptosis, the kidney can freely move from the retroperitoneal space to the abdomen or pelvic region, returning to its place on its own.

Causes of nephroptosis

Physicians identify a number of predisposing factors that lead to the development of nephroptosis:

  • rapid and sharp weight loss;
  • received injuries of the waist or abdominal region. During a stroke, ligaments that hold the kidney in the retroperitoneal space may be damaged;
  • pregnancy and childbirth in women. During the gestation of the fetus, the woman's organism undergoes constitutional changes characterized by weakening of the muscles of the abdominal wall;
  • obesity and rapid body weight gain.

Women more often than men suffer from this pathology. Most often, nephroptosis is observed on the right side.

Danger to the body

Each kidney includes large blood vessels - the renal artery and the vein, and the kidneys leave the ureters. Vessels are almost wide and short in structure. When the kidney is displaced from its physiological space, the vessels of the organ must contract and stretch. As a result, normal blood circulation in the kidney is severely disrupted. In addition, the displacement of the kidney leads to the bend of the ureter, which threatens the acute retention of urine in the organ. All these abnormalities create prerequisites for the development of a serious inflammatory process of the kidney - pyelonephritis.

Symptoms of nephroptosis

The clinical picture of the disease directly depends on the stage of nephroptosis. Urologists distinguish three stages of nephroptosis:

  • Nephroptosis of the 1st degree is characterized by the absence of complaints and clinical symptoms. With palpation of the abdomen, the doctor can find a kidney there.
  • Nephroptosis of the 2nd degree is characterized by the appearance of pain in the lumbar region of the pulling and aching nature. Sometimes painful sensations occur in the form of seizures, intensifying when the patient's position changes. On examination with a doctor, the kidney is easily probed in the hypochondrium. In the analysis of urine, a protein and a high content of red blood cells are detected. The urine is turbid.
  • Nephroptosis of the third degree is characterized by pronounced pain sensations. Discomfort and pain bother the patient almost constantly. In parallel, there may be manifestations of dyspepsia - nausea, vomiting, excessive salivation, stool disorders. The patient becomes irritable, complains of fatigue and anxiety. The kidney can descend into the pelvic area. Clinical analysis of urine shows abnormalities, while urine itself is turbid and has a sharp odor.

Nephroptosis can be unilateral and bilateral. Most often in urology, there is a unilateral right-sided nephroptosis. The displacement of both kidneys is very rare and is more often caused by a congenital anomaly in the development of the renal ligament apparatus. Painful sensations in this disease can occur after intense physical exertion or weight lifting. Over the years, the condition of the patient only worsens. The pain syndrome can be provoked even by an ordinary cough or sneezing. Often against the background of nephroptosis, patients develop renal colic, during which the patient becomes restless, can not occupy a comfortable position of the body, becomes covered with a cold sweat. The attack of renal colic provokes reflex contraction of muscles and can lead to vomiting, involuntary urination and defecation. Skin covers of the patient at an attack pale, there is a decrease in blood pressure and a rapid heartbeat.

Nephroptosis in Pregnancy

Very often this pathology occurs in women during pregnancy. If the nephroptosis was in a woman even before the onset of pregnancy, but did not manifest itself clinically, then after giving birth, the patient's condition only worsened. Even if nephroptosis was not previously, then after childbirth this condition can develop against a background of stretching of the ligamentous apparatus of the kidneys and weakening of the muscles of the abdominal press.

To avoid this disease during pregnancy and after childbirth, the expectant mother must perform daily simple physical exercises aimed at strengthening the muscles of the pelvic organs and the anterior abdominal wall. Of course, before starting the classes, you need to get permission from the district gynecologist who leads the pregnancy. If a woman has a threat of miscarriage, then all physical activities are excluded.

In addition, it is important to understand that, in itself, omission of the kidney does not pose a threat to the life of the growing fetus, but the consequences of organ displacement may negatively affect the course of pregnancy as a whole. That's why all pregnant women regularly undergo a comprehensive examination, which necessarily includes ultrasound of the pelvic organs and retroperitoneal space, urine and blood tests. This approach allows us to identify any deviations from the norm at the initial stage of their development, and timely treatment starts eliminates the risk of complications posing a threat to the fetus. Progression of pathology by the urinary system is an indication for an urgent hospitalization of a pregnant woman, since with the development of renal failure, it is impossible to naturally nurture and deliver.

Complications of kidney displacement

In the absence of timely medical care, the progression of nephroptosis can lead to the development of serious complications:

  • Pyelonephritis - develops against the backdrop of stagnant phenomena in the kidneys, creating a favorable environment for the reproduction of pathogenic microflora, which in turn causes an inflammatory process in the renal-pelvic system.
  • Hydronephrosis - develops as a result of a violation of the outflow of urine due to ureteric inflexion or torsion.
  • Secondary arterial hypertension - develops as a result of a violation of the physiological circulation in the kidney. With the development of this complication, hypertension is poorly amenable to correction with medications.

Diagnosis of nephroptosis

When making a diagnosis, it is very important to collect an anamnesis of the patient. At the reception of the patient should tell the doctor about the injuries and injuries of the lumbar region, inflammatory and viral diseases, health, periodicity and intensity of pain. It is necessary to mention the intensification or stagnation of pain when changing the position of the body and with physical exertion.

The doctor conducts a general examination of the patient - palpates the lumbar region and the anterior abdominal wall. Palpation should be carried out not only in the horizontal position of the patient's body, but also in the vertical position. Often this way it is possible to detect nephroptosis.

In order to clarify the diagnosis, the doctor appoints the patient to undergo additional examinations - radiography and instrumental research. The simplest and most accurate way to determine nephroptosis is ultrasound and x-ray of the retroperitoneal space and abdominal cavity with the introduction of contrast medium intravenously.

Additional methods for diagnosing nephroptosis are excretory urography, angiography and pyelography. These studies are conducted to the patient in the vertical and horizontal positions of the body. Thanks to modern apparatus and methods of diagnosis, it is possible not only to confirm the omission of the kidney, but also to accurately determine the degree of the development of the disease.

Treatment of nephroptosis

To treat the omission of the kidney conservative and surgical methods of treatment are used. Conservative treatment of nephroptosis is possible at the initial stage of development of pathology and consists in performing physical exercises, adherence to a special diet, wearing a bandage and a massage course. The bandage should be worn daily, dressing him in the morning, lying down, having first taken a deep breath. For each patient, the bandage is selected strictly individually and can be custom-made.

Contraindications to wearing a bandage are adhesive processes in the abdominal cavity, in which the displaced kidney is fixed in one place.

Physiotherapy with the displacement of the kidney is a whole complex of exercises that are aimed at strengthening the muscles of the anterior abdominal wall and the lumbar region. These exercises contribute to the creation of normal pressure in the abdominal cavity, thanks to which the kidney can hold in a physiological position. Physical exercises must be performed in the morning, on an empty stomach, after drinking a glass of clean water without gas. The main part of the exercises is performed in the position on the back, so the patient needs to prepare a place for classes and lay a soft mat. All exercises should begin with a respiratory warm-up. The total duration of therapeutic exercise should not exceed 20 minutes.

In addition to physical exercises, the patient is shown adherence to a special diet. Food should be high in calories and contain a small amount of salt. For each patient, the food ration is written individually, depending on the degree of omission of the kidney, the physique of the patient and a number of other factors.

Surgery is necessary in the event that nephroptosis occurs with complications. The complications of omission of the kidney include such conditions:

  • long and intense pain that interferes with the patient's normal lifestyle;
  • development of chronic pyelonephritis;
  • violation in the work of the urinary system;
  • the appearance of a large number of erythrocytes in the analysis of urine;
  • hydronephrosis;
  • persistent increase in blood pressure.

The patient is prepared for the operation within 10-14 days. During this period, the patient is prescribed anti-inflammatory drugs to exclude the spread of the pathological process and pathogenic microflora with blood flow throughout the body. A few days before surgery, the patient is recommended to occupy a position in the bed with an elevated foot end. This is the position that the patient must occupy for several days after the operation.

During the operation, surgeons perform fixation of the displaced kidney in a normal position, which at the same time retains its physiological mobility. After the operation, the patient is given a light laxative medication in the next 2 weeks of the rehabilitation period, in order to avoid excess muscle tension in the anterior abdominal wall during the act of defecation. As a rule, the outcome of the operation is always favorable. More patients are fully recovered. Within six months after the surgical intervention, the patient is restricted by physical activity.

Today, for the surgical treatment of nephroptosis, the laparoscopy method is used. Such an operation is more easily tolerated by patients than with cavitary intervention. In addition, laparoscopy significantly reduces the period of rehabilitation rehabilitation.

Yoga at the omission of the kidney

In the course of the studies, it was found that yoga exercises have a beneficial effect on the muscles of the abdominal and lumbar region. Many exercises can strengthen the ligamentous apparatus of the kidney, thereby restoring it to its place. Of course, this is relevant at the initial stages of the development of pathology.

Prevention of ovulation of the kidney

To prevent the development of nephroptosis, you must carefully consider your health. This is especially true for pregnant women who are at risk. Timely registration for pregnancy regular examinations at the gynecologist will help to identify the disease at the initial stage of development, which increases the chances of a successful outcome of treatment and prevents the development of complications.

If a person is injured in the abdomen or lumbar region, you should definitely see a doctor!

| 4 December 2014 | | 1 802 | Uncategorized