When expressed renal malformations fetus is not viable and die in early pregnancy, while the fetus with softer abnormalities usually survives.About 10% of children born with potentially serious abnormalities of the genitourinary system.
fetal development kidneys - an extremely complicated process.Primitive is night (metanephric) laid on each side of the pelvic region.Then, with a further increase in the bottom of fruit, each of which begins its upward movement to the place of their final localization (migration) while turning around its own axis (rotation).An important impetus for the further development of the primitive kidney is merging them with the ureteric bud.Disorders migration or rotation underlie most frequent kidney abnormalities.Furthermore, during fetal development may merge two primitive kidneys to form one big kidney.
renal anomalies are characterized by three main parameters:
• Defeat can affect one or both kidneys.
• In one kidney can combi
• Some anomalies are asymptomatic, but the impact of adverse factors, such as infections, helps to identify defect.In case of severe abnormalities may develop kidney failure at or soon after birth.
Anomalies of the kidneys are not subject to correction.These include:
• Pelvic kidney is left in the pelvic area.Formed as a result of violation of migration during fetal development.Most of these anomalies are asymptomatic.
• Fusion of kidneys.Perhaps in different versions, the most frequent horseshoe kidney.The migration process is usually not broken.
• «clinker» kidney as a formless mass lumpish, located in the pelvic region.Formed by fusion of the kidney and violating migration.This rarely causes kidney pathological symptoms.
• Cross dystopia of the kidney.One kidney is located on the opposite side, close to the other kidney.
• Thoracic kidney.It is located in the chest cavity, which may be due to a violation of the diaphragm (fibro-muscular partition separating the chest and abdominal cavity).This is a very rare anomaly, surgical repair is extremely difficult.
• agenesis (congenital absence) of the kidney.There, if the embryo has not happened bookmarks bud from which were to develop urinary organs.Bilateral renal agenesis results in the death of the embryo.
The ureter is a muscular tube through which urine flows away from the kidneys to the bladder.In the early stages of development, the formation of a number of anomalies, which often lead to a violation of the passage of urine.Violation of the merger ureteric bud (primitive kidney drainage system) with the mesonephros (primitive embryonic kidney) stops the further development of the kidney (aplasia).In other cases, there is hypoplasia of the kidneys to the formation of cystic structures (dysplasia) aplasia and renal dysplasia often
rudiment of the ureter may split in two, and give rise to a number of blind ending ducts, which are sent down the ureter.Sometimes it is possible infection of these processes with the development of pain.Another version of the anomalies encountered in growing into the germ of two kidney ureteral processes - in this case, a doubling of the kidneys.Each of them has its own ureter, which empties into the bladder alone or merged with another.Twice the kidney drainage system is often accompanied by pain as a result of urine from the underlying casting in the overlying part of the kidney.
urorektalnoy septum defect
a result of pathology urorektalnoy walls (between the beginnings of the genitals and rectum) is sometimes kistoobraznoe expansion of ureter, the protruding into the lumen of the bladder - ureterocele.A small degree of ureterocele is very common and usually does not cause problems.Significant expansion can become a place of formation of urinary stones.The sharp narrowing of the mouth leads to obstruction of the ureter.Often ureterocele, the reflux of urine, and the doubling of the kidneys combined in one patient.By common birth defects of the lower urinary tract include:
• rear urethral valves - the formation of two folds of mucous membrane of the urethra urethra, which leads to a violation of urination;
• hypospadias - incomplete development of the urethra, in which its outer opening is located on the bottom surface of the penis or scrotum, instead open on the head of the penis.
• bladder exstrophy - defect in the anterior wall of the bladder and the abdominal wall below the navel.At the same time there are also deformation of the penis, undescended testes in the scrotum and inguinal hernia, and the girls - the splitting of the clitoris.
• Eksgrofiya cloaca - a heavy defect in which there is a separation of the bladder into two parts (each of which flows into the ureter), and hypoplasia of the penis.Perhaps the involvement of the small intestine and anus, as well as it is possible combination with congenital anomalies of spinal hernia.
• epispadias - a defect of the upper wall of the urethra.When combined with the defeat of the sphincter of the bladder the patient may suffer from incontinence.Early diagnosis and surgical correction of the defects are of paramount importance for patients with congenital anomalies of the kidney and bladder.Operations are conducted in large specialized centers with extensive experience in the treatment of urogenital malformations in children.In the capable hands of most of the anomalies of the urinary bladder successfully be corrected.