renal ectopia - migration of the kidneys
What is renal ectopia ?
Renal ectopy is an uncommon urinary malformation in which the kidney is not located correctly in the lumbar fossa. It is possible that this condition is low pelvic or iliac. Renal ectopy is generally the result of a failure of upward migration of a kidney from its origin in the lesser pelvis. Superior (thoracic) ascension of the kidneys is a rare situation. Complications of renal ectopy may include:
Obstructions: Obstructions of the uretropelvic junction and vesicoureteral reflux, which can prone to urinary tract infections, are more common in ectopic pelvic situations.
Renal dysplasia: Renal dysplasias, which are malformations of the kidney structure, can be linked to renal ectopia.
Congenital malformations of the ureters: Crossed renal ectopia, a rare variant of Renal ectopy, is often linked to congenital malformations of the ureters, which may include a urethrocele (a pouch-like filling filled with transitory tissue that communicates with the uretropelvic junction).
What are the symptoms of kidney ectopy in adults ?
Symptoms of renal ectopy in adults may vary depending on the position of the kidneys and associated complications. Here are some possible symptoms:
Recurrent abdominal pain: One of the most common symptoms in adults with Renal ectopy is recurrent abdominal pain.
Urinary signs: Patients with renal ectopy may also present with urinary signs such as as hematuria (presence of blood in the urine) and urinary tract infections.
Abdominal mass: An abdominal mass can sometimes be detected during a physical exam.
How to diagnose renal ectopy in children ?
The diagnosis of renal ectopy in children is mainly based on clinical and radiological examinations. The following steps should be followed to diagnose renal ectopy in children:
Clinical examination: Signs such as vesicoureteral reflux, lithiasis or Obstruction of the pyeloureteral junction can be detected by clinical examination.
Empty renal compartment radiography: Renal ectopia can be detected by empty renal compartment radiography , particularly if the kidney is in the pelvic or iliac position.
Ultrasound: To diagnose renal ectopia in children, ultrasound is a a noninvasive diagnostic test that can provide information about the position, size, and structure of the kidney.
Scintigraphy: 99mTc-DTPA and 99mTc-DMSA scintigraphy can be used to assess renal function and detect renal ectopy, particularly if associated with lower pole malrotation or fusion.
Computed tomography (CT): CT can also be used to diagnose ectopia renal, particularly if associated with malrotation or fusion of the lower poles.
What are the possible complications of renal ectopia ?
Possible complications of renal ectopy include:
Recurrent abdominal pain: One of the most common complications of renal ectopy is persistent abdominal pain.
Recurrent urinary tract infections: Abnormal position of the kidneys can lead to recurrent infections of the urinary tract.
Urinary Obstructions: Urinary obstructions may be linked to renal ectopy, especially if the kidney is in the pelvic or iliac position.
Vesicoureteral reflux: A potential complication of renal ectopy, particularly in cases of crossed renal ectopy, is vesicoureteral reflux.
Are there non-surgical treatment options for kidney migration ?
There is no non-surgical method to treat kidney migration. An anatomical malformation called renal ectopy requires surgery to correct the position of the kidney and prevent any potential complications. The position of the kidney, the presence of complications and the unique needs of the patient determine treatment options. If renal ectopy is asymptomatic and does not pose a risk of complications, regular monitoring may be recommended in certain cases.
Can kidney ectopy cause fertility problems?
Although the relationship is usually weak and many cases of kidney ectopia are asymptomatic, kidney ectopia can potentially cause fertility problems. These fertility problems may be caused by potential complications of kidney ectopy, such as urinary tract obstructions and recurrent urinary tract infections.
What are the associated risk factors ?
Risk factors associated with renal ectopy include:
Frequent pelvic or iliac position: The risk of urological complications increases when renal ectopy is lower pelvic or iliac.
Associated urological malformations: Renal ectopia may be linked to urological malformations such as vesicoureteral reflux, which can increase the risk of complications.
Associated genital malformations: Renal ectopy can also be linked to genital malformations, which increases the risk of complications.
How to prevent complications ?
It is essential to diagnose the condition early and implement appropriate management to prevent complications associated with renal ectopy. The following preventive measures can be taken into account:
Early detection: Early diagnosis of renal ectopy can be made before the appearance of complications.
Regular monitoring: Regular monitoring of kidney function and kidney position can help find complications early and provide appropriate assistance.
Treatment of complications: Long-term complications can be avoided by treating associated complications to renal ectopy, such as recurrent urinary tract infections and urinary obstructions.
What is the surgical correction procedure ?
Surgical correction of renal ectopy depends on the position of the kidney and associated complications. Here is an overview of the surgical options available to treat kidney ectopia:
Nephrectomy: If the ectopic kidney is severely damaged or if there is a risk of complications, a nephrectomy (surgical removal of the kidney) may be necessary in certain cases.
Nephropexy: The surgical procedure known as nephropexy involves fixing the kidney in its normal position using sutures or other surgical techniques.
Ureteropexy: Ureteropexy is a surgical procedure that involves fixing the ureter in its normal anatomical position using sutures or other techniques.
Ureteral reimplantation: A surgical procedure called ureteral reimplantation involves reimplantation of the ureter into the bladder to correct vesicoureteral reflux.
What is the prognosis after surgical correction ?
Particularly if renal ectopy is diagnosed early and treated correctly, the prognosis after surgery is generally good. However, the prognosis may vary depending on the position of the kidney, associated complications and the specific requirements of the patient. In most cases, surgical correction of renal ectopy improves the patient's quality of life and prevents potential complications.