Neuromuscular dysplasia of the ureter - Causes, Symptoms and Treatment .MF .
Neuromuscular dysplasia of the ureter - a congenital or acquired malformation, which manifests itself in violation of the neuromuscular system and the body, respectively, its motility.
Neuromuscular ureter dysplasia
Causes of ureteral neuromuscular dysplasia
To date, the causes of congenital neuromuscular dysplasia of the ureter are uncertain.Scientists theorize weight, but none of them can be called a fairly probable.It was found that the big difference in the development of pathology is the use of alcohol and smoking during pregnancy.It is also proved that nedieticheskoe fatty food, radioactive radiation, certain chemicals and drug agents may also affect the development of congenital neuromuscular dysplasia of the ureter.
As for the acquired form of the disease, there is a list of immediate causes are more or less known.It is believed that the most common cause of neuromuscular dysplasia of the ureter obstruction is nadpuzyrnogo his department.The cause of the obstruction, in turn, can
It is possible to influence the development of disease and inflammatory processes.Among them, in the first place, it is possible to allocate pyelonephritis, wherein the infectious process can extend to the ureter.
Traumatic injuries of the ureter and the strong emotional stress can also be a cause of neuromuscular dysplasia of the ureter.
symptoms of neuromuscular dysplasia of the ureter
Symptoms of the disease depends on the stage.In the initial stages, when kidney function is still not broken, the patient may not express any complaints.As a rule, they have a pathological process is registered for planned routine inspection, or to see a doctor about some other pathology.
first clinical symptoms observed already after the patient's kidney function is disturbed.Patients starts to disturb the general weakness, malaise, persistent headaches.On examination, a marked pallor of the skin and unpleasant smell of acetone from the mouth.Later edemas may appear, which are localized usually in the lower extremities and around the eyes.
pain syndrome, which, in theory, would have to be accompanied by disease, is often absent.The reason for this is a violation of the sensitivity of the ureter, which is considered one of the directions of the pathogenesis of the disease.
Radically opposite situation can be observed at rupture of the ureter when urine fills the retroperitoneal space.Then the patients complain of a sharp and intense pain that occurs on one side of the lumbar region.
If there is a person of at least one of the above symptoms, he should immediately seek for consultation to the urologist, as the clinical picture of the disease is not always comparable to the morphological changes.In other words, even with minimal symptoms, the patient may be a serious dysplasia stage neuromuscular ureter.
Diagnostics neuromuscular dysplasia of the ureter
General blood and urine tests at the neuromuscular dysplasia of the ureter, as a rule, are not informative.Exceptions may be cases where the disease has arisen as a result of obstruction of the ureter kidney stones.
excretory urography is used for accurate diagnosis.It lies in the X-ray study of the pelvic organs following intravenous administration of contrast material.The pictures can be detected by a huge size ureter, which may even exceed the size of the bladder.When serial X-ray noteworthy long stagnation of urine in the ureter and poor evacuation of the latter.
excretory urography: neuromuscular dysplasia of the ureter
Ultrasound examination makes it possible to define a large reservoir in the retroperitoneal space, filled with a substance similar in consistency with the liquid.
If you examine the mucous membrane of the bladder using a special optical device, which is called cystoscopy, we can see a moderate hyperemia of the latter, as well as more relaxing ureteral orifice, from which stands out the sluggish stream of urine.
Not so long ago in urological practice widely used method urokinematografii, which is based on registration of peristaltic contractions of the ureter.As a rule, when neuromuscular dysplasia of the ureter marked quite rare peristaltic waves or, more generally, the absence of the latter.
treatment of neuromuscular dysplasia of the ureter
Many urological research helped to come to the conclusion that any conservative treatment of neuromuscular dysplasia of the ureter is absolutely hopeless.In this situation, the only effective method is surgery.To date, more than 200 suggested techniques, among which to choose the most effective is really difficult.
Whichever method is not carried out the operation, its purpose is to reduce the size of the cavity of the ureter and the restoration of the normal passage of urine.Generally, in most cases performed resection of the distal ureter, which most often is the most advanced.After that passage of urine is reduced by sewing the stump of the ureter into the bladder wall.The operation ends stratified sew the wound and applying an aseptic bandage.
rehabilitation after illness
is mandatory antibacterial prophylaxis of secondary infection, since it is known that urine falling on the surgical wound area, creates very good conditions for the development of infection.For this purpose can be used antimicrobials broad-spectrum macrolide or fluoroquinolones.The combination of azithromycin and ofloxacin is well recognized all over the world.
for better healing of postoperative wound dressings should be carried out daily with the processing area of the operational scar antiseptic alcohol solutions.It is possible the use of physiotherapy treatments, magnetic therapy type or darsonvalization.
Feeding habits and way of life
Since renal dysfunction is a legitimate step in the development of neuromuscular dysplasia of the ureter, all patients with this problem mandatory dietary table is assigned the number 7 on Pevzner.Such patients are not allowed to eat salty, sour, fried and peppered foods that can stimulate diuresis, disrupting kidney function.
for about three months after surgery, patients are advised to adhere to a sparing mode with limited physical exertion.Strong pressure on the anterior abdominal wall and lumbar region can cause rupture of the seams and differences of post-operative wounds.
Treatment folk remedies
Treatment folk remedies at the neuromuscular dysplasia of the ureter is an absurd notion because of the fact that no additional research methods to put such a diagnosis is impossible.All those procedures that are often recommended by traditional healers, do not bring any positive results and are a waste of not only time but also money.Plus, the normal treatment delay can only exacerbate the problem and lead to more serious consequences and complications.
Complications neuromuscular dysplasia of the ureter
most common complication of neuromuscular dysplasia of the ureter is chronic renal failure, which develops due to constant stagnation of urine in the renal pelvis cavity.Over time this leads to a thinning of the renal parenchyma and renal dysfunction.Patients progressing gradually common symptoms, which ultimately ends renal coma.If there is no adequate treatment for this stage of disease outcome, usually lethal.
less formidable, but not least, a common complication should be considered as vesicoureteral reflux.This clinical condition is a lack of ureteral valve, in which urine from the bladder cavity begins to throw back into the ureter.In principle, the complication can not be called unexpected, as it is quite predictable in the development of neuromuscular dysplasia of the ureter.
The clinic pathology can be observed and the gap ureter.This usually occurs when an excessive filling of the ureter and the impact of small external stimulus, such as blunt trauma to the lumbar region.The urine entering the retroperitoneal space, becomes the cause of severe pain, which in some cases may even become the cause of a painful shock.Breaks the ureter is an absolute indication for surgical intervention.When patients refuse surgery or impossibility of the latter, there is one hundred percent mortality in patients.
Prevention neuromuscular dysplasia of the ureter
prevention should be based In congenital form of the disease, primarily on the elimination of all those negative factors that can cause the development of congenital anomalies.
Preventing the acquired form of the disease is the timely treatment of those pathologies that can lead to neuromuscular dysplasia of the ureter.First of all, urolithiasis and ureter tumor.If these diseases are identified at an early stage and the necessary treatment policy will be made in time, it is likely that in the future, the patient does not know about neuromuscular dysplasia of the ureter.
forecast neuromuscular dysplasia of the ureter
prognosis for recovery - relatively favorable.Even after the surgery can not hope to cure disease, because it is hidden, especially in the dysfunction of higher neural structures.
Forecast for life can be considered favorable only after proper and adequate treatment.In case of delay or improper tactics can be registered and fatal cases.
forecast for performance - relatively favorable.change of place of work can be recommended to patients with pathology Complication.
Ed.urologist, sexologist-andrologist Plotnikov AN