Ureteral obstruction
Classification according to ICD-10 | |
---|---|
Q62.1 | Atresia and (congenital) stenosis of the ureter |
N13.1 | Hydronephrosis in ureteral stricture, not elsewhere classified |
N13.5 | Kink and stricture of the ureter without hydronephrosis |
ICD-10 online (WHO version 2019) |
The ureteral stenosis ( UAS ) is a narrowing of the transition from the renal pelvis to the ureter . It is usually congenital; it can rarely be caused by an adjacent blood vessel.
Symptoms
The constriction leads to a build-up of urine in the renal pelvis, which can lead to abdominal and flank pain, especially after drinking more fluids. Urinary tract infections occur more frequently due to the obstruction to drainage, and the enlarged renal pelvis is rarely palpable as a "tumor".
Diagnosis
Today, the suspected diagnosis is usually made during an ultrasound examination of the kidneys, in many cases already prenatally . A one-sided enlargement of the renal pelvis is then noticeable. A kidney scintigraphy can be performed to estimate the functional part of the affected kidney and to quantify the extent of the flow obstruction .
therapy
If less than 40% of the urine drains from the renal pelvis and if there is pain or repeated infections, an operation should be performed. As a rule, the ureter, including the narrowness and part of the renal pelvis, is cut off and then the ureter is sewn back into the renal pelvis and the renal pelvis is closed (surgery according to Anderson-Hynes).
If the kidney function is less than 10% on the affected side, removal of the kidney may be indicated.
Web links
- Guideline. German Society for Pediatric Surgery for Ureteral Stenosis
- Guideline for pediatric urology. (PDF; 189 kB) Austrian Society for Ultrasound in Medicine (ÖGUM)