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Complications Renal and ureteric stones can lead to significant morbidity owing to urinary tract obstruction, infectious complications and loss of renal function. Bilateral obstructing ureteric stones or ureteric calculi in a solitary kidney can present with a...

Congenital megaureter The normal ureteric diameter in children up to 16 years is 0.50–0.65 /uni00A0 mm. If the ureter is dilated by more than 7 /uni00A0 mm, it - is classed as a dilated or megaureter. This may occur with or without obstruction or reflux. Most c...

Congenital pelviureteric junction obstruction Congenital PUJO is the most common cause of unilateral hydronephrosis with an incidence of 1 in 500 live births. It may result from intrinsic obstruction secondary to an aperistaltic segment at the PUJ due to mus...

Diagnosis The diagnostic approach can be classified into investigations done in the emergency setting and those done in the non emergency setting. The most common acute presentation of stone disease is - ‘ureteric colic’. Small 3- to 5-mm calculi are usually r...

Ectopic kidney This occurs when the mature kidney fails to reach its normal location in the lumbar region. The incidence is 1 in 500–1200. An ectopic kidney ( Figure 82.1 ) may be found anywhere along the path of ascent: pelvic, iliac, abdominal and rarely th...

Ectopic ureters An ectopic ureter is one that drains to regions other than the bladder. Ectopic ureters are almost always associated with ureteric duplication and are bilateral in 10%. The female - to-male ratio is 7:1. In females, the ectopic ureter opens eit...

Endourology Endourological procedures are the current preferred mode of - treatment owing to their minimal invasive nature, technological - advancements in instrumentation and more e ffi cient energy sources for stone fragmentation. Current energy sources are pn...

Epidemiology The lifetime prevalence varies from 1% to 20% and the causes are multifactorial. Recurrence of stone disease is high, with 50% having recurrence within the first decade of diagnosis. Non-modifiable factors associated with stone formation /uni25CF ...

Genetic renal cysts These cystic renal lesions have a known genetic inheritance. They are usually accompanied by involvement of other organ systems and present earlier in life than sporadic renal cysts. Dependent 2. Wide 3. Funnel shaped 4. Maintain good...

Horseshoe kidney This is the most common renal fusion anomaly , occurring in about1 in 400 live births with a male predominance. The isth mus lies at the level of the fourth to fifth lumbar vertebrae (fused lower poles). This causes failure to ascend and rotat...

INFECTIONS UTI is very common and a ff ects all ages and both sexes. It can cause significant morbidity and is a rare cause of mortality in patients with serious comorbidities or in patients with urinary tract obstruction. Recurrent UTI is more common in women,...

Introduction No content extracted automatically.

Learning objectives To know: Congenital anomalies of the kidney and ureter • Classi /f_i cation of renal cysts • Classi /f_i cation, de /f_i nitions, pathogenesis and management • of urinary tract infections

Multicystic dysplastic kidney Multicystic dysplastic kidney (MCDK) is the second most common cause of an abdominal mass in newborns after hydronephrosis due to PUJO. The unilateral incidence is 1 in 1000–4000 live births. It has a ‘bunch of grapes’ appearanc...

Non-endourological surgical management Open surgery such as pyelolithotomy and anatrophic nephro lithotomy is reserved for complex and infected stones with anatomical abnormalities. High-risk stone formers should be advised to follow preventive measures to red...

Non-surgical management of stone disease This involves watchful waiting, medical expulsive therapy , SWL and stone dissolution therapy . Watchful waiting Patients with small (<5 /uni00A0 mm), non-obstructive, asymptomatic, lower pole renal calculi with preserv...

Pathogenesis Stone formation results from a cascade of events that occur during and after urine formation. When the concentration of culprit salts such as calcium and oxalate overwhelm inhibitory factors (e.g. citrate, potassium, magnesium, Tamm–Horsfall muco...

Pregnancy Renal colic is the leading cause of non-obstetric hospital admission in pregnancy . The physiological changes that take place during preg - nancy include an increase in glomerular filtration rate by 50%; increased excretion of calcium, uric acid and...