Valves ureter - Causes, Symptoms and Treatment .MF .
ureter valves - it dublication mucosa of the ureter, which occurs usually in the lower divisions and it hampers the normal evacuation of urine in the bladder.
Causes of ureteral valve
cause of ureteral valve is the fact that at the birth of the ureter is the same length as an adult.This ensures that it acquires a helical form, and in its lower section valves are formed that can only consist of the mucosa or all layers of the wall body.Because newborn ureteral lumen is much wider than that of an adult, these valves do not interfere with the normal flow of urine.Normally, around the age of four, the valves are reduced, and the patient did not even know about the existence of the latter.
frequent clinical cases where age-valves do not disappear, and it interferes with the normal flow of urine.First, a partial ureteral obstruction, which eventually turns into a full.
In addition, the literature describes cases where the ureter valves had acquired origin.In such a situation was
Symptoms of ureter valves
Symptoms of the disease is determined by the stagnation of urine in the renal pelvis cavity.As a result, there is stretching the renal capsule, which appears very strong pain in the lumbar region.Until the complete obstruction of the ureter pain is ongoing moderate.When complete closure of the lumen of the ureter symptom acquires the character of colic.In this situation, patients are restless, they complain about the sharp deterioration in the general condition and severe pain in the lumbar region.
With long-term course of the disease, marking the permanent stagnation of urine in the renal pelvis cavity, patients can develop kidney stones.Then observed typical symptoms of kidney disease when patients concerned about recurrent pain in the lumbar region, which is accompanied by a violation of urination.
If untreated ureter valves can lead to quite serious consequences, so if a person has the above clinical picture, it is necessary to immediately consult a urologist for diagnosis and treatment.
Diagnostics ureter valves
In the first stage of medical research, when executed by the common blood and urine tests, changes usually can not detect.Only when joining kidney disease, patients may experience an increased amount of salt in the general analysis of urine.
different techniques, but the most effective is considered excretory urography can be used to verify the diagnosis.To do it intravenously injected contrast agent, which is then excreted by the kidneys.If the X-ray perform pelvic examination, you can see the relief of the mucous membrane of the ureter, which is celebrated during the formation of the valve protrusion ustupoobrazno its walls.
excretory urography: ureter valves
As already mentioned, the ureter valves are mainly formed in the bottom of his department.It gives a chance for the detection of the last during cystoscopy.To this end, a special optical device, and the doctor examines him the mucous membrane is injected into the cavity of the bladder.When the ureter valves there is a lack of urine receipt of one kidney, as well as at very low location of the ureter, can be seen and the valve itself, which is visualized in the form of a small protrusion of the mucous membrane.
Treatment of ureteral valve
ureter valves require treatment only when there is obstruction of its lumen and the patient observed symptoms of colic.First of all patients underwent cystoscopy with ureteral stenting attempt to restore the normal flow of urine.A stent is a tube minimum diameter which, via a cystoscope, introduced into the lumen of the renal pelvis, while the other end remains within the lumen of the bladder.If urologist be able to pass the place ureteral obstruction, the tube can remain in its cavity to three months.
If stenting proved to be ineffective or to execute it simply is not possible, patients surgery is recommended.Once access to the ureter, which is performed retroperitoneal procedure, focusing on the details of additional methods of research, find a place valve formation.The ureter is opened and the valve is excised, ushivaya mucosa.
When multiple valves excised ureter they simply can not, therefore, resort to partial resection of the ureter.Passage of urine is reduced by stitching the ends of the ureter or using artificial prosthesis from hypoallergenic material indifferent.
in a situation where it is impossible to carry out surgery, and the threat of urosepsis increases with each passing minute, the patients underwent puncture of the renal pelvis.Under local anesthesia in lumbar puncture performed skin and soft tissue before reaching the catheter into the lumen of the renal pelvis.In today's urological clinic this procedure is carried out under the control of ultrasound.In the absence of this imaging method it is performed on anatomical landmarks.After the puncture, the needle is introduced pelvis special catheter, which is used by the flow of urine.It is there before the time of surgery, and when the absolute contraindications to last for life.
rehabilitation after illness
First, rehabilitation after surgery is based on antibacterial prophylaxis of secondary wound infection.Quite often in the surgical field can get traces of urine, which is a good substrate for the development of infection.To prevent the latter, it is necessary for one week to take antibiotics broad-spectrum, such as ceftriaxone or ampicillin.
widely after operations on the kidneys used physiotherapy treatments.The purpose of their application is the early healing of surgical wounds.
Feeding habits and lifestyle
After surgery on a kidney diet for all patients assigned table number 7 Pevzner.A feature of this diet is to limit the consumption of fried, fatty, salty and acidic foods.Thus, reducing the load on the kidneys, which improves and facilitates the process of regeneration in the healing.
Also, all patients within three months are not allowed to perform work requiring heavy physical exertion.If their immediate profession is related to physical work, then the patient is recommended to change jobs.
Treatment folk remedies
As already mentioned, to unload the kidneys in case of acute ureteral obstruction, the need for urgent invasive procedures.Thus, conservative treatments, including people, can not be considered effective.A similar appeal to professionals only delays the time that could be spent on adequate professional medical help.
Complications of ureteral valve
most common and most dangerous complications in the ureter valves should be considered as a complete obturation of the ureter, which results in a renal colic.Prolonged urinary retention in the renal pelvis urinary toxins into the blood, causing urosepsis - general blood poisoning.If at this stage the patient is not transferred to the resuscitation department for emergency treatment, the clinical condition may end lethally.
described clinical cases where, because of ureteral obstruction occurred last break.This led to an inflammation of adipose tissue of the retroperitoneal space.If untreated, the inflammation is usually becomes purulent fusion of retroperitoneal fat and ends with the same blood poisoning.
If patients do not have the acute and chronic urinary retention in the cavity of the renal pelvis, then they develop nephrolithiasis.Such patients are, in addition to eliminating the valve ureter, and still require treatment of kidney disease.If their treatment is important to remember that the cause of obstruction may not be the valve, and stone.This is very important when choosing a treatment strategy as obturation stone can be removed without surgery.
Prevention ureter valves
As already mentioned, from the neonatal period, and up to four years ureter valves are physiological phenomenon.The reasons why this vestigial organ does not disappear with time, and many of today it is impossible to identify any certain.It is very important in children to monitor the physical and psychomotor development of the child, as it was his delay may cause the development of the ureter valves.
In addition, you must undergo periodic inspections at the urologist, who can timely detect ureteral valves and prevent the development of its full obturation.
If a patient by routine inspection, ureter valves have been found, it must undergo periodic studies urologist in order to determine the dynamics of disease.If there is a tendency to increase the progression of the valve, the patient is better to spend a planned surgery, after which much less complications than after Urge.
forecast ureter valves
Forecast for life - favorable.An exception may be those rare cases when urosepsis develops.
forecast for performance - favorable.As a rule, even the surgery is not a reason for a career change.An exception may be during the first three months after surgery, when it is necessary to avoid heavy physical exertion.
With timely treatment specialist and adequately conducted treatment, the prognosis for recovery is also favorable.
Ed.urologist, sexologist-andrologist Plotnikov AN