Among all types of neoplasms in the kidneys, the solitary cyst occupies a leading position - this pathology occurs most often. The exact causes of the disease, scientists and doctors have not yet been called, but this ignorance is more than compensated by thorough diagnosis and treatment. Today, it is quite easy to recognize a solitary cyst in a patient, and the methods of therapy are perfected almost to perfection.
Solitary cyst of the kidney
A solitary cyst can be found in different parts of the body, not only in the kidneys. The very name "solitary" means that the cyst is large and solitary. Most often, a single solitary cyst is formed in the kidneys, but two neoplasms may appear.
In rare cases, doctors diagnose almost symmetrical cysts - on each kidney. At the diagnosis the doctor necessarily marks, with a cyst of what kidney he has business - right and left. Most often, the tumor is found in the left organ, with men becoming victims of the disease after 55-60 years.
The cyst itself is a cavity in an organ formed by its walls and filled with some liquid or other contents. The cyst is called simple: it has thin walls, there are no partitions or separate chambers inside.
ICD-10( full name - International Statistical Classification of Diseases and Health Problems) classifies the renal solitary cyst in the category of diseases of the genitourinary system. The code for ICD-10 is N28.1, the acquired cyst. For a single innate cyst, the cipher is Q61.0.
Causes of
Although the kidney cyst is a disease that has been fairly studied, doctors have not yet managed to give an unambiguous answer, why does a solitary one appear? Today, there are 2 basic theories on this subject, according to which and distributed solitary neoplasms into 2 types: acquired and congenital.
You can meet different statistics about what kind of renal cyst occurs most often: some sources claim that the ratio is equal, others generally give the palm to the congenital neoplasms. But small studies, which are often organized in large Russian hospitals, report that the majority of patients with this diagnosis are over 50 years old, men. That is, the cyst in these cases is acquired.
Congenital cystic formation, according to scientists, occurs if the kid's kidneys and ureters are irregularly formed during a mother's pregnancy. To be more precise, the rudiments of some renal tubules are incorrectly connected to the outflow channels.
There is such a phenomenon on the background of different diseases:
- after a kidney injury;
- with urolithiasis( stones provoke stagnation of urine);
- for renal infections;
- for inflammation( eg, pyelonephritis);
- because of cancer.
Symptoms of
The solitary renal cyst can measure from a few millimeters and up to 10 cm. A small neoplasm can be completely asymptomatic, some patients live with such a cyst for many years and do not even suspect its presence.
But if the cystic vesicle grows, then when it reaches a certain size, it starts to press on the neighboring tissues and bring the person tangible discomfort.
The following symptoms occur:
- severity and aching pain in the side, from the side of the cystic kidney;
- murky color of urine( with stagnant fluid);
- hypertension( renal hypertension);
- reduced or no urine;
- admixture of blood in the urine( the most dangerous symptom).
If an infection is added to the solitary cyst, then the kidney pains and colic intensify, go to the abdomen. The patient has a fever, chills. In this case, the symptoms do not depend on the kidney on which the solitary cyst "settled" - on the right and left. The significance is the size of cystic formation, the presence of infections, concomitant diseases, and the like.
Chronic renal failure with a solitary cyst develops extremely rarely, but some of its signs can be observed in patients with a large cyst. It is thirst, dry mouth, increased amount of urine( polyuria).
Diagnosis
A routine examination, anamnesis and laboratory methods will not help the doctor identify a solitary cyst. Sometimes, when palpation, a kidney tumor is felt, but in this case the neoplasm does not always turn out to be a cyst.
Therefore, the main methods for diagnosing solitary kidney cysts are instrumental:
- Ultrasound examination. Tomography of the kidney.
- Excretory urography.
Often, cystic lesions are detected accidentally when an ultrasound scan is performed for other indications.
On the ultrasound, the solitary cyst has the following features:
- smooth, rounded shape, thin walls that are clearly visible against the background of the cortical renal layer;
- in the place where the cyst connects to the kidney parenchyma, you can recognize the acute angle - the so-called beak symptom;
- cyst pushes the renal calyx, from which the pelvis consists. Sometimes it squeezes the pelvis itself.
Differential diagnosis is important when it is necessary to distinguish the solitary renal cyst from malignant neoplasms. In this case, excretory urography in combination with nephrotomography is indispensable, X-rays are also made and cysts are punctured. That is, the study of serous contents.
1 - normal renal tissue;2-cyst.
Treatment of
In many cases, the solitary cyst grows to a certain size and stops, without causing any inconvenience and without provoking complications. Therefore, if the renal cyst does not exceed 20 mm, doctors use expectant management. Special treatment is not assigned to the patient, ultrasound and urinalysis are performed once a year, and specialists are monitoring that the cyst does not start to grow.
If cystic education is associated with infection, antibiotic therapy is necessary.
In severe cases, surgery is required: laparoscopic or conventional.
The main indications for surgical intervention in the diagnosis of "solitary cyst of the kidney" is:
- severe lumbar pain;
- impaired urine output( small volume, cloudy hue, etc.);
- size of the cyst is more than 4 cm;
- is the probability of developing a cancerous tumor.
After the autopsy the doctor necessarily evaluates the condition of the organ, looks for malignant changes. Depending on this, the patient can wait for kidney removal, resection, excision of the cystic walls, or vyluschivanie the neoplasm.
Forecasts
Traditionally, urologists refer to a solitary cyst as a safe neoplasm - the prognosis with this diagnosis is quite favorable, the cyst rarely regenerates into a malignant tumor.
If it does not increase in size and there are no indications for operations, then the patient can safely live with such a diagnosis and not worry: the quality of life solitary renal cyst is absolutely not affected.
But when the cystic bubble begins to expand, there is a risk of dangerous complications:
- Rupture of a solitary cyst.
- Infection and suppuration inside the cyst.
- Chronic pyelonephritis.
- uremia( poisoning of the body with toxic products of protein metabolism).
- The degeneration of a simple cyst into a malignant tumor( sometimes the tumor develops directly in the cystic cavity or "grows" from its wall).
- Chronic renal failure.
Because the exact causes of the appearance of a solitary cyst have not been identified, there is also no way to prevent this ailment. But in our power - to reduce the risk of kidney disease: be careful of hypothermia, timely treat infections, avoid injuries and eat right.