The leakage of urine at double kidney. Full and incomplete doubling of the kidneys: causes, manifestations, treatment and is it possible to get pregnant with renal abnormalities

The date: 19.10.2019

Currently, incomplete doubling of the kidney is considered the most common form of pathological development of the urinary system organs. This disease is essentially not considered a disease and does not have its own signs, but at the same time the patient's high tendency to affect the kidney by nephropathies of chronic nature is detected.

With the development of incomplete doubling, there may be two options for pathology:

The kidney receives food from one artery and has two pelvis.
It has only one lochank, but at the same time two artery, which come out of the aorta separately.

Causes of incomplete doubling

The incomplete doubling of the left or right kidney develops due to the formation of two infectious foci at once in metanephrogenic blaster. There is no complete disconnection of blasthema, even despite the appearance of two cup-making systems at once - this is due to the preservation of the capsule coating of the organ.

Each half of the pathological authority has its own blood supply. The vessels of this organ can exit a common pillar - so the separation is formed already nearby, not far or the sinus itself, or can be separated directly from the aorta. Some arteries located inside are able to move from one kidney to another - it is very important to take into account when conducting resection of the organ.

Partial doubling is a type of doubling of the organ, which is characterized by a feature of the structure and structure of the body, when the doubling of vessels and renal parenchyma is produced without splitting the purels. It turns out that the sinus of the kidney is divided by a jumper from the parenchyma to two separate departments. Such division provokes an increase in the size of the organ.

It is important! As a rule, the incomplete doubling of the organ is not at all dangerous and does not imply any clinical detention in contrast to the development of a full doubling. The only danger in this situation becomes a variant at which a cup of a decrain system is doubled, as well as uretera. To set the right diagnosis, it is required to produce excretory.

Clinical picture of pathology

The incomplete doubling of both kidneys or one of them is manifested by the doubling of renal vessels and parenchyma, but is not accompanied by a doubling of lochs. Usually the upper part of the affected organ is less than the lower part.

Usually, two ureterals of doubled kidneys are immediately opened by holes directly in the bladder, occasionally occurs the splitting of the ureter, which has one hole in the pelvic department and one barrel, in its upper part there is a splitting and join with lochs. Ureterals are capable of split at different levels. If there are two ureteral holes at one side from the bladder, then the hole of the lower pellet is adjacent to the hole of the pitchfill, located on top. Often the ureters are intertwined in their path - usually one - twice.

A narrowing is formed at the site of the combination of two ureters, which in the place of their complete merger interferes with normal urodynamics even if the anatomical pavement of this department is preserved. Basically, the upper part of the right or left kidney suffers, which slows down the continuous fluid flow, therefore contributes to the development of kidney hydronephros and the formation of the chronic inflammation process. If the pathological process does not develop in double kidney, then clinical symptoms are not observed. In this regard, the disease is more often diagnosed by chance.

Symptomatics of the development of pathology

Signs of incomplete doubling of the left kidney or right in children mainly consist of infectious damage to the urinary channels - this process is considered to be an indication for a comprehensive examination.

A person with a diagnosis of incomplete doubling of the kidney can live a long life without complaints and violations of health status, and pathology is randomly detected at ultrasound examination. Doubling affecting ureters is more often the cause of bubble-ureter reflux due to the infallinal operation of the circuit functions of the mouth. Reflux is usually implemented in the lower part of the forked kidney. The mouth of the ureter in the upper part of the organ is narrowed, and it provokes the formation of a cyst, which flows into the lumen of the bubble and causes the expansion of the ureter.

Diagnostic events. Varieties and holding

Usually, the incomplete doubling of the kidney does not imply a special diagnosis. Full doubling is detected after the start of development of the inflammation process. Any doubling can be easily detected by radiography or ultrasound.

The damage diagnosis is established on the basis of the results obtained after cystoscopy, excretory urography, ultrasound. It makes it possible to examine the work of each of the universal kidney parts, its anatomical and structural changes. An important role in the diagnostic process is played by ultrasound and computed tomography.

It is important! With explicit changes in one of the half of the kidney and the deterioration of its functions, retrograde pyelography is used.

Clinical studies indicate a high frequency of a variety of pathologies from the opposite side of the kidney doubling. When doubling at once both kidneys is often diagnosed with acquired or congenital pathology - dysplasia, hydronephrosis, and the like.

The need and organization of the treatment of incomplete doubling

Treatment of the disease primarily implies the therapy of the acquired infectious process or pathology, such as a urolithiasis or pyelonephritis. In itself, incomplete doubling is not a disease, but this pathology significantly increases the risk of developing the process of inflammation. If the defeat of the double kidney acquires a chronic course and is poorly treatable, the doctor prescribes the patient to carry out resection.

It is important to know that the detection of incomplete doubling of this body in humans is recommended to begin to adhere to a healthy lifestyle. In mandatory, it is necessary to prevent the effect on the body of toxic factors - for this it will be necessary to abandon the use of alcoholic beverages, from smoking.

The doctor also revises drug therapy, paying particular attention to the diet. It is important to remember that the kidney will be properly functioning until it becomes hard because of the wrong nutrition and adverse living conditions.

In mandatory, it is necessary to organize events aimed at hardening the body, and also gradually keep physical training. Thus, a person can warn many defeats and complications that provoke kidney doubling. A specialist can help correctly form a diet and lifestyle.

From kidney development anomalies, the doubling of these organs is the most common. More often, the problem is observed in girls on one side of the body, but sometimes it happens two-way.

Doubling the kidney - what is it?

The doubling of the kidney Modern medicine recognizes congenital pathology at which there is a complete or partial doubling of the renal system. Anomaly is more than 10% of all vices of the urinary system, occurs about 150 cases of posthumous opening, and in newborns - in 1 case out of 140 children appearing on the light. One-sided doubling is 88% of all registered pathologies, doubling both kidneys - 12%. Code of ICD-10 - Q63.8 (other congenital kidney abnormalities).

When doubling the kidney visually looks like two organs each with its blood supply.

Anomalous kidney, of course, has significantly large sizes than normal. Physical problems and serious inferiority of the function of the system by itself, the double kidney does not cause, but contributes to the development of a number of diseases during life.

Causes

Pathology can be exclusively congenital, it is laid during the period of intrauterine development of the fetus. It often matters the hereditary location when one of the parents and close relatives has a similar anomaly. Also on the body of the mother and the fetus can have a pathogenic effect of a number of factors, as a result of which the kidney with defects of the structure are laid during embryogenesis.

Among such factors are distinguished:

Obtaining radioactive, x-ray irradiation.
Work on harmful production.
Poisoning drugs, poisons, intoxication.
Reception of drugs with teratogenic action.
Heavy avitaminosis.

The result of such factors becomes the appearance of two foci of the growth of the kidneys, when 2 cup-making system is formed. The final separation does not happen, so the double kidney is covered with a common fibrous shell. The vessels are separated separately from the aorta, or have a common trunk, which is then divided into two parts and is suitable for each kidney individually. Sometimes arteries inside the backward kidneys penetrate from one abnormal organ in another, which can create certain difficulties during the operation.
On the video that the kidney doubling is:

Forms of pathology

As already noted, the anomaly is one-sided and double-sided.

But in medical practice, the differentiation of pathology on such forms is of great importance:

Full doubling. And the left, and the right kidney has its own ureter, its own cup-making system. Lohanks are located in parallel, connected only with a small coastal of connective tissue. That cup, which is at the top, as a rule, is underdeveloped, and the lower pellet is fully functional. Each of the twin kidneys, in fact, is a separate organ.
Incomplete doubling. With this anomaly, the dual is a parenchyma organ, its vessels are also doubled. A cup and male system develops without doubling. The top of the abnormal kidney is less than the bottom.

Most often there is an incomplete doubling of the left kidney. The right body is amazed at an order less often. The underdeveloped part of the double kidney resembles the condition of the organ during dysplasia.

On the photo of the doubling of the kidney

Symptoms

The manifestations of incomplete doubling of the kidney in a newborn and people during life is usually absent. Sometimes a person does not suspect the existing anomaly at all, and he learns about it by chance. There is no consequences for life and reduce its quality incomplete doubling.

Full doubling also does not lead to the appearance of symptoms, but only until different complications are superimposed on it. This can happen at any age, but in children until 8-10 years old is diagnosed less often.

Usually, with a long existence of anomaly without surgery, it is observed:

Regular inflammation;
Hydronephrosis with urine accumulation in lochank;
The reverse flow of urine from the ureters.

Symptoms of full doubling kidney can be:

Pain in the field of back;
Pain when tapping at the lower back;
Sometimes - an increase in body temperature;
Swelling;
Weakness;
Often emerging renal colic;
Arterial hypertension;
Pain when urination;
Occasionally - urinary incontinence.

The infection can move downward by the bladder, urethra with the appearance of the characteristic cystitis clinic, urethritis.

Diagnostics

Usually the detection of an anomaly occurs in a planned manner. Thanks to the compulsory screening in children up to the year, the doubling of the kidney is often detected in the child already on the ultrasound of 1-6 months. Thus, the ultrasound of the kidneys is the main method of diagnosis, which suggests this anomaly.

Radiography, MRI, CT. Allow you to consider in detail the form and structure of the kidneys.
Excretory Urography. It helps to see the ureters, the expansion and doubling of the cup-making system.
Doppler scanning. It is used to assess the vessels feeding the kidneys.
Cystoscopy. A specialist visualizes the mouth of the ureters, their number and location.

Inflammatory changes in the urinary system and the effectiveness of its work is confirmed by the analyzes. Apply:

General urine analysis;
Urine baucanalysis;
"Renal" biochemistry of blood;
Analysis of the smear from the urethra on bakposposev, etc.

Often, an experienced specialist may assume the presence of a doubling of kidney in the fetus during pregnancy. Ultrasound at 25 weeks and later may well give the necessary information. Separately, you need to say about pregnancy with doubled kidney. Such women are necessarily carefully observed by a nephrologist, a urologist during the whole period of gestation, they regularly hold a number of laboratory and instrumental analyzes. In the presence of renal failure, the testimony for the operation pregnancy is contraindicated.
Double kidney on ultrasound:

Treatment and forecast

Specific conservative treatment under this anomaly does not exist. But due to the increased risk of developing various complications, it is important to carry out dynamic control over the health of a person with a doubled kidney. In prophylactic procedure, diuretic, phytosters and other drugs appointed by a specialist are taken, and also regularly pass the urine and perform kidney ultrasound. A diet with a reduced amount of salt, acute food, smoked, and other products that can cause renal overload is important. Be sure to abandon smoking, alcohol use in minimal quantities.

With the appearance of complications, treatment is symptomatic and pathogenetic.

Acute and chronic inflammation and violation of urine outflows are treated by receiving:

Antibiotics;
Spasmolitics and painkillers;
Vegetable preparations (kidney tea, corn storks, lingonberry, cranberries, etc.).

In the presence of a serious occurring, often exacerbating chronic pyelonephritis, as well as expressed bubble-ureteral reflux, should be planned surgical treatment. Also, one half of the kidney or ureter is removed with stones, hydronephrosis, the absence of the functioning of the organ, and the operation (Geminefretecome) is carried out at any age. The appearance of a tumor or the absence of a technical possibility of a kidney separation becomes an indication for complete nephrectomy. Renal failure will require a kidney transplant from a donor or hemodialysis.
On video about the causes and treatment of kidney development anomalies:

What threatens?

The prerequisite for the development of complications becomes the presence of renal dysplasia and disorders of urodynamics due to double ureter. As a result, in the underdeveloped part of the kidney, there is incomplete emptying of the pelvis, urine is stared, which causes a variety of diseases.

Most often, the inflammation of the kidney is observed - pyelonephritis, which is especially common with full doubling, combined with the ectopia of the ureter's hole, ureteral reflux, bubble reflux, urgertzel. Pyelonephritis is observed in 24% of doubling cases.

Other possible consequences:

Cabinets in the kidneys - 21%;
Hydronephrosis - 14%;
Nephroptosis - 3%;
Tuberculosis Kidney - 36%;
Tumors - 2%.

The kidney with the presence of an anomaly is strongly vulnerable, besides, the infectious process in it often goes to a healthy organ. Therefore, the patient is important not to transfer, it is necessary to eat right away, immediately treat all inflammation and infections to keep health at a high level.

The doubling of the kidney is one of the most frequent congenital anomalies of the structure of the urinary system, in which the modified kidney has the kind of double body. They seem to be combined together, and each of them has its own parenchyma and blood supply through two renal arteries, and in most cases a more functionally significant and developed body is the lower share of education.

In this article we will acquaint you with the reasons, signs, differences, methods of diagnosis and treatment of full and incomplete doubling of the kidney. This information will help to make an idea of \u200b\u200bsuch a defect in the development of the urinary system, and you can ask questions to the attending physician.

During the splitting of the kidney, the blood supply and the parenchyma of the anomalies are always split, and the ureter and renal pelvic doubling are not always exposed. An extensive ureter can be in the bladder that occurs in such a defective development unit, connecting with the main one, or has an independent "gate" into the urinary bubble cavity. Such a change in the structure of the urinary tract at the fusion site of two ureters is accompanied by a narrowing, which causes the difficulty of the urine outflow and its reverse reflux to the lochank. Subsequently, such functional disorders contribute to the development.

Doubling the kidneys can be complete and incomplete, single or two-way. According to statistics, the frequency of such a malformation of the urinary system is 10.4%. 2 times more often such an anomaly of the kidneys is revealed in girls and is usually one-sided (approximately 82-89% of cases). By itself, it does not carry a threat to health, but its presence often contributes to the development of various kidney diseases.

Most often, such an anomaly of development is provoked by genetic causes and is revealed in children at an early age. The vice can have different morphological configurations, and only detailed diagnostics allows you to choose the right tactics of its treatment.

Incomplete doubling kidney

The leading cause of kidney doubling is a genetic defect.

In case of incomplete doubling of the kidney, each of the ureters of the split organ does not flow into the bladder separately. They are combined and included in the urinary bubble cavity by a common duct. Such a kind of doubling kidney occurs more often. Not fully doubled the right, and left kidney. In this case, such a morphological structure of the changed body is observed:

both subsidiaries have a common capsule;
a cup-laughter system does not double, but functions as a single;
the splitting of the renal arteries occurs in the field of the kidney sinus or these two artery are departed directly from the aorta;
each part of the twice kidney has its own blood supply.

In some cases, a person with incomplete twisted kidney can not feel the present anomaly, and pathology is randomly detected when diagnosing for other diseases.

Full doubling kidney

With full doubling of the kidney, two subsidiaries are formed. Each of these organs has its own ureter and a cup-glass system. One of these kidneys may have underdeveloped magnifier, and its ureter can fall into the bladder not at the physiological level.

With the full twist of the kidneys, each of the resulting organs is able to filter urine, but the functional disorders arising from this often lead to the development of various diseases of the urinary bodies:

hydronephrosis;

Sometimes the full doubling of the kidneys is accompanied by the occurrence of an atypical morphological configuration, in which the ureter formed in the subsidiary is not connected together with the main and does not flow into the bladder, but opens into the intestinal lumen or vagina. In such cases, the child will be seeded from urine from the rectum or vagina.

Causes

The main reason for doubling the kidney lies in the formation of two foci of induction of differentiation in metanephrogenic blastoma. Such a violation occurs even during intrauterine development. Most often, such pathological changes arise due to the transfer of a mutated gene from parents or under the influence of teratogenic factors affecting the body of pregnant and fetus.

Such a reasons affecting the body of the future mothers can contribute to the doubling of the kidney:

ionizing radiation;
avitaminosis and deficiency of minerals during pregnancy;
reception during the tooling of the fetus of hormonal drugs;
transferred during pregnancy viral and bacterial infections;
poisoning by nephrotoxic drugs or poisonous substances;
active and passive smoking, alcohol intake during pregnancy.

Symptoms

In most cases, the doubling of the kidney flows absolutely asymptomatic or detected by chance during preventive inspections, in the diagnosis of other diseases.

Often, pathology manifests itself only after its complications occur. One of the most common consequences of kidney doubling in children becomes an infectious damage to urinary tract. In addition, the narrowing of the ureters at the place of their merger can lead to a violation of blood circulation, deterioration of urine outflow and its opposite reflux. Subsequently, such changes are capable of provoking the development of hydronephrosis.

With full doubling of the kidney, the patient may appear the following symptoms:

signs of infectious damage to urinary organs (frequent urination, increase in temperature, pain and uncomfortable sensations in urination, pus in the urine, etc.);
pain in the area of \u200b\u200bthe belt (from the doubling side of the kidney);
positive symptom of Pasternatsky;
expansion of the upper departments of the urinary system;
reflux urine from ureters;
the appearance of kidney colic (in the development of urolithiasis);
urine leakage (if the ureter is included in the intestine or vagina).

The probability of the occurrence of certain symptoms from the above-described signs of doubling the kidney is variable and depends on the form of anomaly.

Pregnancy with kidney doubling

A woman with doubled kidney should plan a child conception in advance. To do this, she needs to go through a complete diagnostic examination: to pass urine and blood tests, to conduct an ultrasound and, if necessary, other instrumental research. After analyzing the data obtained, the doctor will be able to determine the possibility of conception planning. The offensive of pregnancy under such pathology is contraindicated in identifying renal failure and testimony for surgical treatment.

If during the contraindication examination to conceive a child, then after the occurrence of pregnancy, the woman should be observed by a physician and urologist. When identifying any complications, it will be shown to hospitalize in the urological department for the treatment of emerging complications. As clinical observations show, in most cases the doubling of the kidney in a pregnant woman rarely leads to severe complications. As a rule, doctors succeed only with the help of conservative methods of treatment to control blood pressure indicators, eliminate swelling and other consequences of this anomaly.

Diagnostics

In most cases, the doubling of the kidneys is diagnosed in the intrauterine period during a planned ultrasound of pregnant.

The doubling of the kidney in the fetus can be detected when conducting an ultrasound at the 25th week of pregnancy.

Typically, signs of doubling kidney are detected by a Uz-diagnostic doctor when examining a patient about pyelonephritis or urolithiasis. In case of suspected such anomaly, the patient is recommended to pass the following additional research:

radiography (review shot);
ascending and excretory;
radioisotope scanning;
cystoscopy.

In addition to the instrumental methods of the survey, laboratory and are prescribed.

Treatment

If the doubling of the kidney proceeds without complications, the patient recommends a dispensary observation from the urologist. It will be necessary to periodically hold ultrasound kidneys per year at least once a year and take urine tests. For the prevention of complications, compliance with the following practitioners of the doctor is required:

avoid hypoints;
minimize the consumption of saline dishes and foods rich in fatty acids;
comply with personal and sexual hygiene rules for the prevention of infectious diseases.

Therapeutic treatment

Medical treatment with kidney doubling is prescribed to patients in which this anomaly led to the development of pyelonephritis, hydronephrosis or urolithiasis. The symptomatic therapy plan may include such funds:

antibiotics;
spasmolytics;
anesthetic drugs;
anti-inflammatory and diuretic films;
compliance.

Surgery

Surgical treatment for doubling the kidney is prescribed only in cases where the emerging complications cannot be eliminated using conservative therapy and lead to severe impaired functioning of the urinary system. The following states may become indications of its conduct:

urolithiasis, not amenable to conservative therapy;
bubble-ureteral reflux;
heavy forms of hydronephrosis;
uretrocele (expanding urethra with cavity formation).

In some cases, the doubling of the kidney leads to the development of urolithiasis, the manifestations of which cannot be eliminated by therapeutic measures. If the stone is very often worried about the patient, the instrumental or surgical techniques are used to remove it. Sometimes the removal of urinary counters can be carried out by crushing them with electromagnetic waves (remote lithotripsy method). However, such a way of destroying stones is not always possible. Some large accretions can be removed only with surgery.

Stones of ureters can be removed after crushing through. If such an endoscopic procedure turns out to be ineffective, then the removal of the concretion is carried out after the surgical opening of the bladder.

With severe forms of hydronephrosis and bubble-ureteral reflux, the following types of interventions can be carried out:

gemineectomy or nephrectomy - removal of one or more kidney segments;
the imposition of a ureterouro -urethero or pyelopeloanastomosis is the creation of anastomoses to eliminate the reverse cast of urine;
tunneling of ureters - antireflury intervention, aimed at creating a lumen for the normal passage of urine.

Surgical operations are carried out only if it is impossible to eliminate the effects of hydronephrosis. With severe violation of the kidney function, dialysis is recommended for a patient. If the kidney ceases to cope with urine filtering, nephrectomy is prescribed to the patient. Subsequently, the patient can be carried out by a kidney transplantation from the donor.

With an abnormal shift of the ureter in the intestines or vagina, a corrective operation is carried out, aimed at restoring the normal impact of the ureter into the urinary bubble cavity.

In the event of a urethrocel, such types of operations can be performed for its excision:

ureterocystoneostomy - the removal of urethrocene and the creation of a new mouth of the ureter;
transuretral dissection - endoscopic operation to remove the urethrocep.

The purpose of such interventions is aimed at stitching the ureter into the intact wall of the bladder.

To which doctor to turn

When revealing the doubling of the kidney, the patient is recommended to observe the urologist. For dynamic observation of the kidney anomaly will be carried out uzzi and urine tests. For more detailed clarification of the clinical picture of pathology, the following methods of research of the urinary system are appointed.

With the development of incomplete doubling, there may be two options for pathology:

The kidney receives food from one artery and has two pelvis.
It has only one lochank, but at the same time two artery, which come out of the aorta separately.

It is important! As a rule, the incomplete doubling of the organ is not at all dangerous and does not imply any clinical detention in contrast to the development of a full doubling. The only danger in this situation becomes a variant at which a cup of a decrain system is doubled, as well as uretera. To produce a faithful diagnosis, it is required to produce an excretory urography.

The damage diagnosis is established on the basis of the results obtained after cystoscopy, excretory urography, ultrasound. Excretory urography makes it possible to examine the work of each of the doubted kidney parts, its anatomical and structural changes. An important role in the diagnostic process is played by ultrasound and computed tomography.

It is important! With explicit changes in one of the half of the kidney and the deterioration of its functions, retrograde pyelography is used.

both subsidiaries have a common capsule;
a cup-laughter system does not double, but functions as a single;
the splitting of the renal arteries occurs in the field of the kidney sinus or these two artery are departed directly from the aorta;
each part of the twice kidney has its own blood supply.

In some cases, a person with incomplete twisted kidney can not feel the present anomaly, and pathology is randomly detected when diagnosing for other diseases.

hydronephrosis;
pyelonephritis;
urolithiasis disease;
nephroptosis;
tuberculosis;
tumors kidney.

Such a reasons affecting the body of the future mothers can contribute to the doubling of the kidney:

ionizing radiation;
avitaminosis and deficiency of minerals during pregnancy;
reception during the tooling of the fetus of hormonal drugs;
transferred during pregnancy viral and bacterial infections;
poisoning by nephrotoxic drugs or poisonous substances;
active and passive smoking, alcohol intake during pregnancy.

In most cases, the doubling of the kidney flows absolutely asymptomatic or detected by chance during preventive inspections, in the diagnosis of other diseases.

With full doubling of the kidney, the patient may appear the following symptoms:

signs of infectious damage to urinary organs (frequent urination, increase in temperature, pain and uncomfortable sensations in urination, pus in the urine, etc.);
swelling of the limbs;
pain in the area of \u200b\u200bthe belt (from the doubling side of the kidney);
positive symptom of Pasternatsky;
expansion of the upper departments of the urinary system;
reflux urine from ureters;
the appearance of kidney colic (in the development of urolithiasis);
an increase in blood pressure;
urine leakage (if the ureter is included in the intestine or vagina).

The probability of the occurrence of certain symptoms from the above-described signs of doubling the kidney is variable and depends on the form of anomaly.

The doubling of the kidney in the fetus can be detected when conducting an ultrasound at the 25th week of pregnancy.

radiography (review shot);
ascending and excretory urography;
radioisotope scanning;
cystoscopy.

In addition to the instrumental methods of the survey, laboratory tests of blood and urine are prescribed.

avoid hypoints;
minimize the consumption of saline dishes and foods rich in fatty acids;
comply with personal and sexual hygiene rules for the prevention of infectious diseases.

antibiotics;
spasmolytics;
anesthetic drugs;
anti-inflammatory and diuretic films;
compliance with diet for the prevention of urolithiasis.

urolithiasis, not amenable to conservative therapy;
bubble-ureteral reflux;
heavy forms of hydronephrosis;
uretrocele (expanding urethra with cavity formation).

Stones of ureters can be removed after crushing through a cystoscope. If such an endoscopic procedure turns out to be ineffective, then the removal of the concretion is carried out after the surgical opening of the bladder.

With severe forms of hydronephrosis and bubble-ureteral reflux, the following types of interventions can be carried out:

gemineectomy or nephrectomy - removal of one or more kidney segments;
the imposition of a ureterouro -urethero or pyelopeloanastomosis is the creation of anastomoses to eliminate the reverse cast of urine;
tunneling of ureters - antireflury intervention, aimed at creating a lumen for the normal passage of urine.

With an abnormal shift of the ureter in the intestines or vagina, a corrective operation is carried out, aimed at restoring the normal impact of the ureter into the urinary bubble cavity.

In the event of a urethrocel, such types of operations can be performed for its excision:

ureterocystoneostomy - the removal of urethrocene and the creation of a new mouth of the ureter;
transuretral dissection - endoscopic operation to remove the urethrocep.

The purpose of such interventions is aimed at stitching the ureter into the intact wall of the bladder.

excretory and ascending urography;
cystoscopy;
radioisotope scanning;
MRI, etc.

Incomplete and complete doubling of the kidney in many cases does not carry health hazards and is often detected by chance when conducting preventive ultrasonic research of the kidneys or during a survey about other diseases. In the absence of any symptoms, such a vice does not need treatment and requires only dispensary observation. In some cases, this anomaly of the urinary system leads to the development of complications: pyelonephritis, hydronephrosis, bubble-ureteral reflux and urolithiasis. If such consequences of the kidney pathology appears, the decision on the need for conservative or surgical treatment is determined by the doctor. As a rule, the doubling of the kidney has a favorable forecast and rarely needs to carry out operations to remove and transplantation of the body.

Uz-diagnostics doctor tells about the doubling of the kidney:

Ultrasound kidneys (kidney doubling)

There were lesions of inflammatory or other character.

note

Often, such an anomaly does not affect the state of health and quality of the child's life, many adults only in old age will learn about such their anomalies, not celebrating problems with the urogenital system over the past years. The functionality of the organ, this deviation often does not affect.

Doubling kidney in a child: definition

Regarding other defects of development and anomalies, the doubling of the kidney is most common. According to statistics, girls with doubled kidney predominate over the boys, and one-sided lesion prevails over the bilateral anomalies.

Modern doctors understand the term "doubling of the kidney" of an exclusively congenital defect.With it, it is formed a partial or complete doubling of the organ on one side (less often - bilateral).

On average, the prevalence of anomaly is about 10% of all known defects of the blade system of children. It is noted in 1 case by 150 newborns, while one-sided vice accounts for up to 89%, and the remaining 11% remains for bilateral lesions.

Visually it looks like two struck kidneys, in the area of \u200b\u200bone of their poles, and each of them has its own blood supply. Additional kidney is usually smaller in size than normal (although options are possible and greater than). In this case, serious physical defects and the defective functioning of the urinary system, the presence of an additional kidney does not forms. However, such an anomaly can be combined with other defects of development or predisposes to the formation of certain diseases throughout life.

If an abnormal kidney exceeds the usual, additional vessels can be detected in it, the amount of kidney cups or pelvis is increased. The kidney part of the kidney is almost completely duplicated, a ureter moves from each kidney, but one is somewhat worse developed.

Is the kidney doubling dangerous for a child?

With the development of ultrasound, a similar anomaly began to identify in children, although it existed before. Many older people learn about the presence of a similar anomaly, having lived a full life without any problems. Therefore, no physical inconvenience or lags in development does not bring such a defect, and doctors often only observe children, recommending parents only full care and control of food, prevention of various lesions of the urinary tract. If any problems arise, the prescription of medicines according to the identified symptoms may follow, the operational correction is required in exceptional cases.

Parents should not worry and panicing about such deviations, there are no special differences in the development of the baby, and it is only important to ensure that the kidneys do not overload and are not inflamed.

What are the reasons for such a defect?

Like many other malformations, the kidney problems occur intrauterine, in the period of laying organs and systems, and obvious influences in each particular case can be a lot, as accompanying. The exact cause of the doctors cannot be called, but there are a number of factors that increase the risk of birth of children with anomalies of the urogenital system:

Harmful habits of parents and their effect on the fruit. This is especially true for the mother, but the impact on the father's body is also important. The admission of alcohol and psychotropic drugs affects the correctness of the bookmark of tissues and organs, especially in the early period of pregnancy. In this regard, the rejection of such habits during the planning period eliminates at least part of risk factors.
toxic compounds penetrating the body with different paths. This is especially important when working in harmful production, contact with chemicals and poisons in everyday life.
high radiation doses affecting fetal fabrics. Especially dangerous, conducting CT or frequent radiography in early pregnancy periods. No less dangerous radiation treatment of certain diseases shortly before pregnancy.
reception of medicines with teratogenic and embryotoxic effect. Such drugs are the greatest danger in the period of conception and up to 12 weeks of pregnancy. Deciding on the appointment of medicines pregnant in this period forms only a doctor to not harm the germin.
a sharp and pronounced shortage of vitamins, mineral components, nutrients. Often it happens with a very poor nutrition of women, starvation and diets, both medicinal and dying.
the influence of heredity. It is often revealed between the presence of a double kidney from parents or a close relative and identifying it in a child. If both parents have a similar anomaly, the chances of getting it in a child increase significantly.

Features of the structure of a double kidney

As a result of the impact of all adverse factors, the formation of at the same time two areas of the growth of the kidneys can become, of which two separate cup-making systems are gradually formed, but completely the kidneys are not separated in themselves, due to the double kidney will be covered with a common fibrous capsule. For each kidney, the vessels will be separate, they depart from the aorta, or one common arterial barrel will take place, then divided into two isolated parts, coming up with each kidney.

In some cases, the arteries inside the double kidney can penetrate from one kidney to another, which can then form certain difficulties, if the abnormal additional kidney is removed.

At ultrasound, double kidney looks larger than usual, one part is more symmetrical and neat, while the second is more active functionally.

Important!

With an additional separate entrance of the second ureter in the bladder, predictions regarding health are better, it reduces the risks of various complications of diseases.

Features of the kidney doubling

For the degree of split kidney, several pathology options can be distinguished. Based on the degree of formation of a cup-making system and kidney tissue:

full doubling kidneyWhen each body has its own ureter, a cup-making apparatus, but they are parallel to one other and lad apart. Both kidneys refer to separately functioning authorities.
incomplete (partial) doublingWhen only the kidney parenchyma and the region of the vascular system becomes doubled, while the cup-laughter with a ureter's ureter.

Doubling is possible to be left or right, in extreme variants it is possible to doubling both kidneys.

A special variant of vice becomes the doubling of a cup-lowering system with a single parenchyem and kidney capsule.

Doubling kidney in children: signs of problem

For the abnormalist itself, a typical asymptomatic course, but the defects of development predisposes to the formation of more frequent diseases of the urinary system as a whole. Typically, symptoms occur when the development of secondary (on the background of the available doubling) of the kidney lesions, but it does not happen in all children and not in all cases. Usually the symptoms of various pathologies are typical for adult age, sometimes advanced.

If we talk about symptoms in general, you can expect:

Inflammatory processes in the field of kidneys and urinary tract
Violation of the urinary in pelvis (delay in urine)
Urination disorders of different species, but usually without pain
Loss of urination control, in case an abnormal ureter of a duplicate kidney grows up with a urethra or vagina
Development (salts in the urine in children, small concrections)
Periods of development of swelling
Episodes.

Often all these symptoms are weakly expressed, manifest only periodically, minor symptoms.

When forming an inflammatory process in the doubled kidney region, it can be typical of:

Long painful character
Disorders of appetite, right up to complete eating
Foreign reactions
Problems with psycho-emotional development, memory and information reproduction.

When the microbes spread to the bladder region and the urethra are attached symptoms or.

What complications are possible when doubling?

If this is a one-way process, the doubled kidney rarely generates complications, and is found randomly. If we are talking about bilateral defeat, such a fortune is more dangerous. In addition, with incomplete doubling, the forecasts are also better than with full duplication of the kidneys. In children with doubling, such pathologies may often occur as:

- Inflammatory process of microbial origin, which involves in the inflammation of the pelvis and a cup of kidneys.
Possible formation , urine delays in the kidney area, which leads to atrophic phenomena.
POSSPOSPOSITION K. When sand and small concreters are formed, which can overlap ureters and lead to obstruction, which forms kidney colic.
If the pathogens penetrate the blood or with the current lymph and actively multiply in the renal tissue. A long-term pathology can not be displayed.
Tumor processes in the added kidney, which is due to the fact that the kidney itself is atypical education for the body. A long tumor itself also does not show, malignant more dangerous in terms of forecast.
Development wandering kidney It becomes one of the complications by virtue of greater mobility of anomalous twin kidney. The stronger the kidney goes down or shifted, the worse the forecasts.

What methods is determined?

Today, along with other countries, we have been used in the first year of life to determine the work of the kidneys, so developmental anomalies are revealed quickly and early. After identifying the doubling of the kidney, a decision is made on the tactics of further observation or treatment. Usually additional surveys are prescribed in the form of radiography with contrasting, or, urography and duplex scanning of kidney vessels to determine the kidney vessels, is also shown.

Equally important is the conduct of a number of analyzes that reflect the functioning of the kidneys and the presence of infection. These include strokes with a urethral canal and, biochemistry urine. As the kid grow and develops, it is conducted to evaluate the kidney functions in the dynamics or control studies to determine the effectiveness of therapeutic measures.

Methods of treatment of kidney doubling

In the case of the full functioning of the kidneys and the absence of secondary complications, there is no need for surgical or in any other treatment. The child will periodically pass prophylactic examinations from the doctor. It may only be necessary to comply with the diet, which normalizes the work of the kidneys. It is important to exclude or reduce the volume of smoked, acute and salty foods, sauces and marinades with salt and pepper, fried food in the diet. These products and dishes significantly affect the work of the kidneys.

With secondary complications, the child is treated accordingly pathology, the decision on the operation to remove the added kidney is taken only if it is amazed by the pathological process.

Pediatric Alain, Pediatrician, Medical Observer