In urological practice there are a large number of various diseases of the upper urinary tract, the cause of which, in 20% of cases, is the deterioration of the quality of water consumed, the environment and stress. However, despite the equal living conditions of men and women, there is a certain differentiation of pathologies of the kidneys, the probability of development of which is more often characteristic of one or the other sex.
Thus, tumors, cysts and atrophic processes, often diagnosed in men, as a rule, are the result of unhealthy food and bad habits, and diseases, the infectious nature of women, are the result of the anatomical features of the organism.
Ultrasound examination of the kidneys, can rightly be considered one of the most informative methods of visualization of the renal apparatus, which does not have any negative effects on the body, which allows it to be used in the diagnosis of pathologies of the urinary system in pregnant women. The need to obtain complete and high-quality information requires some preparation for ultrasound of the kidney in women, which makes it possible to minimize the likelihood of an error in diagnosis.
Indications for ultrasound of the kidneys are usually symptoms and complaints of malaise associated with impaired urine outflow and pain in the lumbar region. It is worth noting that the kidneys, having an extremely complex structure, are a parenchymal organ, so the pain symptom manifests itself only in extreme cases, when the influence of pathological processes causes deformation of the internal or external structures.
In addition, cyclical changes occurring in the female body, in most cases, veil pain symptoms, since menstruation, and sometimes ovulation, is often accompanied by pain in the lower abdomen, back or side. As a rule, an ultrasound of the kidneys is prescribed in the following cases:
- the patient has complaints of systematic aching pain in the lumbar region
- in the urine there is an admixture of blood in significant quantities, that is, visually detectable, or a small amount detected as a result of the analysis (latent hematuria)
- there is a change in body temperature. At the same time, for some diseases of the kidneys, not only its increase, but also a decrease to 35 ºС is characteristic.
- if when using the usual amount of fluid, urine when urinating, has a significantly smaller volume
- there is marked swelling of the limbs or face, not only in the morning, but also in the evening
- there is a steady increase in blood pressure, which is difficult or not amenable to correction with medication.
To perform an ultrasound study of the kidneys and organs of the small pelvis in women, a little preparation is required, which is to follow the recommendations aimed at maximally improving the visualization of the organs being examined. The main problem that can interfere with the implementation of the diagnostic procedure is increased flatulence in the intestines, creating randomly located anaechoic zones that prevent a full examination of the kidneys, bladder and organs of the reproductive system.
In order to get the most reliable results, a woman should stop using products containing rough fiber and capable of causing flatulence a few days before the procedure. The list of such products include:
- black bread or wholemeal bread containing bran
- all types of cabbage (white cabbage, broccoli, etc.)
- milk and dairy products
- carbonated drinks.
With a chronic tendency to gas formation, it is recommended to take activated carbon, at the rate of 1 tablet per 10 kg of patient weight in a single dose, as well as drugs that can reduce the amount of gas in the intestine, for example, Espumizana.
Due to the fact that during the examination the doctor performs a comprehensive examination of all urinary tract, immediately before the ultrasound, you need to drink half a liter of water. This will help to more accurately assess the position and condition of the ureters, renal pelvis and the structure of the bladder in a stretched state.
Optimal results with ultrasound diagnostics of the kidneys, adrenal glands and pelvic organs can be achieved by refusing food intake 6–8 hours before the procedure.
To perform an ultrasound diagnosis of the kidneys, first of all, it is necessary to bare the abdomen and the entire lumbar region, since to determine the condition of the organ, it is necessary to evaluate it from various angles. This inspection technique is called polypositional.
As a rule, at the beginning of the procedure, the patient is lying on his back, and the examination is performed through the abdomen. At the second stage, the doctor asks the woman to roll over to the right and then to the left side, carrying out a detailed visualization of all the renal structures.
At the third stage, the patient must stand upright, inhale and hold her breath, while the kidney, which has a certain mobility, extends from under the rib, allowing you to inspect from a single angle. Determination of the degree of mobility of the kidney, provoked by respiratory activity is carried out during inhalation and exhalation while lying and standing.
Also, ultrasound can be used to make echographic sections. For this, an ultrasonic sensor is installed in the region of the middle part 12 of the rib, directing the radiation at an angle of 30 ° to the body axis and along the long axis of the kidney.
At the end of the procedure, the patient must remove the gel, which is used to improve the contact of the sensor with the body and get dressed. Such an examination allows assessing the anatomy of the kidney, since the 12th rib overlaps the right kidney in the upper part and crosses the left one in half.
Important! When doing an ultrasound of the kidneys, it is not always possible to make a study of the adrenal glands, as a healthy organ is hardly visualized.
A significant increase in the size of the adrenal glands (up to 2 cm), which makes it easy to detect them in the ultrasound picture, may indicate the development of a tumor.
Ultrasound diagnostics of the kidney condition is based on the assessment of the following indicators: the evenness and clarity of the kidney contour (a healthy kidney may not have a completely even, but definitely a clear contour), the size of the kidneys by ultrasound, the presence or absence of differentiation in the organ parenchyma echogenicity in each structural element of the kidney), as well as the degree of visualization of the cup-pelvis-plating system.
At the same time, the normal size of the kidneys should be:
- length from 9 cm to 12 cm
- thickness from 3.5 cm to 6 cm
- width from 4.5 to 6.5 cm.
When diagnosing cystic formations of the kidneys, the accuracy of ultrasound is almost 100%. On ultrasound images, cysts are reflected as echo-negative sites, allowing you to estimate their number and size. No less informative ultrasound and the diagnosis of the causes of violations of the outflow of urine in the upper urinary tract.
As a rule, areas with high echogenicity indicate the presence of calculi that prevent urine outflow. An increase in the size of the kidneys and a decrease in the cavity of the renal pelvis system are evidence of inflammatory processes.
Table: Kidney ultrasound rates
|The form||Oval, bean-shaped|
|Circuit||Smooth or wavy|
|The ratio of (length-width-thickness)||2/1 / 0.8|
|Cup size||cm||Less than 0.5|
|Permissible displacement of the kidneys during inspiration||cm||3.0–7.0|
|Renal vein thickness||cm||1.0–1.2|
|Renal artery thickness||cm||0.5–0.6|
The main purpose of ultrasound of the kidneys during pregnancy is the identification of stagnant processes in the renal pelvis system and related inflammatory diseases of the kidneys. Changing the position of the internal organs due to their increasing uterus, often causes deformation of the ureteral canal, which, in turn, causes difficulty in removing urine from the kidneys and can lead to hydronephrosis.
There are frequent cases of overlap of the upper urinary tract calculus, the displacement of which may also be caused by a change in the position of the kidney, due to compression. It should be noted that the technique for performing ultrasound of the kidneys during pregnancy does not have any differences either at the stage of preparation for the procedure or at the stage of its implementation.
A female organism can be called a perfect, but at the same time fragile system, each link of which requires careful attention to itself. The main purpose of this system can be considered the possibility of carrying and having a child.
It is during pregnancy that the load on many organs and especially on the renal apparatus, which chronic complications significantly complicate and in some cases may threaten the successful pregnancy, increases significantly.
Despite the fact that the ultrasound examination of the upper urinary tract is not a mandatory procedure used to diagnose the pathological conditions of women during pregnancy, in most cases, ultrasound carried out during this period allows you to identify all possible risks in a timely manner and take measures to eliminate the threat to health. .