Endovideosurgical treatment of patients with nephroptosis

Fat capsule plays a large role in maintaining the desired position of the kidney. The pericardial tissue, which is located around the kidney, limits the movement of the kidney and maintains its normal position. If the amount of fiber decreases dramatically, then in this case the kidney not only falls, but can also turn around its axis. But in reality it turns around the vascular bundle.

Development of nephroptosis occurs often due to weight loss. This is one of the factors of its development. If the abdominal kidney has decreased muscle tone, it can also lead to the kidney lowering. With all this, there is not only the omission of the kidney, but also of the other organs of the abdominal cavity. Contributing to the development of nephroptosis are infectious diseases that affect the connective tissue, consisting of the fascia and ligaments. In men, nephroptosis is much less common than in women. The frequency of nephroptosis in men is 0.1%, and in women 1.5%.

There are 3 stages of development of nephroptosis:

• 1 stage. Here, at the entrance through the anterior abdominal wall, the lowered kidney is probed, and then, at the exit, the kidney gradually leaves in the hypochondrium( in reality, the kidney is really felt only for very thin people, as for the rest of the people, it is not palpable).
• 2nd stage. Of hypochondria is already out the whole kidney, while the patient is in an upright position, but if the patient lies in a prone position, then return to the kidney hypochondrium, also have the ability to straighten her arm, more painless.
• Stage 3.Here, in any position of the body, the kidney completely leaves the hypochondrium and is fully capable of moving into the small pelvis.

around its axis kidney already can be rotated in a second step, wherein the start stretch vessels bend Vienna and renal artery, in connection with which the lumen is reduced. All this can lead to venous hypertension, t. E. The outflow of venous blood from the kidney, as well as to a decrease in delivery to the kidney arterial blood( ischemia).As for the third stage, it is possible to violate the outflow of urine due to persistent inflection of the ureter. Therefore, due to nephroptosis in the second and third stages, there may be a violation of the blood supply to the kidneys, both venous and arterial. This leads to the occurrence of pyelonephritis and the greatest development of infection in the kidneys. It is during nephroptosis that pyelonephritis often turns into a chronic stage.

Nephroptosis in the 1st stage is almost imperceptible. In the lumbar region, aching pain may occur. They usually do not exist at rest, but often they manifest themselves under physical stress. They can also occur when moving from a horizontal position to a vertical position. The pain begins to increase, if the degree of omission of the kidney increases. In this case, they can appear in the sacrum or abdomen.

When the patient is experiencing the 2nd stage of the disease, immediately the patient is disturbed by blood supply and urine stagnation may occur, since erythrocytes and protein appear in the urine.

Since the 3rd stage, the kidney pains are constantly showing up. Because of these pains, the patient may be depressed and neurasthenic. At this stage, the patient immediately observed a decrease in appetite and a violation of the functionality of the gastrointestinal tract. With physical activity in the third stage, renal colic may occur due to a large inflection of the ureter. But most often manifested nephroptozoonic pyelonephritis. In the kidneys, veins start to overflow because of venous hypertension, then the veins on the wall of the pelvis and cups can burst, which will lead to the appearance of blood in the urine. If nephroptosis narrowed the renal artery, then often arterial hypertension, which is gradually developing. Less likely may occur hydronephrosis, it manifests itself when an infection is attached.

The doctor probes the patient's kidney to determine the diagnosis of nephroptosis, but first of all he interrogates the patient himself. In the laboratory, urine and blood are analyzed. The mobile kidney is detected using ultrasound. But it is the x-ray method that is the main one in the diagnosis of nephroptosis. Still, the most effective method is excretory urography, that is, a study is carried out using contrast agents. Thanks to this research, the doctor is able to anticipate the exact position of the kidney. After conducting a radioisotope study to clarify the condition of the kidney. In the diagnosis of nephroptosis, venography and arteriography of the kidney have always been considered to be valuable methods. Such a method can not only know the position of the kidney, but also clarify and check the state of the kidney vessels.

Treatment of nephroptosis.

Endovideosurgical treatment of patients with nephroptosis is performed in the absence of such complications:

• wearing a bandage. On the patient, he is usually dressed in the morning, as soon as he gets out of bed, in some cases in the prone position
• strengthening the muscles of the anterior abdominal wall with a special set of therapeutic physical training
• if the patient has a low weight, then it is strengthened by nutrition to increase the amount of fatFiber

Surgical treatment of patients with nephroptosis is performed in such complications:

• disruption of the patient's life due to intense and prolonged pain
• chronic pyelonephritis
• in the loweredTh kidney function of
• has been significantly decreased
• rugged arterial hypertension in the urine observed the blood
• hydronephrosis.

Within 2 weeks, prepare the patient for surgery. That during the operation it was possible to eliminate the spacing of the infection, prescribe anti-inflammatory treatment, adding here the same endovideosurgical treatment. At 20 cm, the leg of the bed rises and the patient is taught to lie in this position, and after performing an operation in 2-3 days. And even after surgery, the patient will need to be in this position. After the operation was successful, the patient should undergo anti-inflammatory treatment for two weeks. Usually, most patients recover completely. After the operation, it is forbidden to exercise for six months.