Cancer Of The Kidney And Ureter Effects,,,,,
Congenital anomalies. Mistakes in development, such as the absence or reduplication of a kidney or ureter, or the fusion of the two kidneys at their lower poles (horseshoe kidney) are not uncommon; these conditions are symptomless unless the malformation interferes with the drainage of urine and predisposes to urinary tract infections. The best defense the urinary tract has against infection is the normal flow of urine along it which flushes any pathogenic micro-organisms to the exterior; any tendency to stagnation invites infection to become established.
Occasionally the valvular mechanism at the lower end of the ureter is defective and allows urine to regurgitate from the bladder into the ureter and renal pelvis during parturition.This 'ureter reflux' may give rise to recurrent urinary tract infections, especially in children. Surgical correction of the abnormality may be required.
Trauma. The kidney may be contused or partially ruptured in an injury to the hack or lower chest. It is frequently difficult to distinguish renal ;njury ions other intra-abdominal damage but the patient is usually shocked and evidence of haematuria confirms the renal injury.
Treatment. General resuscitation treatment for shock is carried out. Intravenous pyelography is then performed to assess the extent of any damage. Surgical intervention is rarely necessary; with bed rest and general nursing care the haelliaturia gradually abates and the kidney ultimately heals with surprisingly little residual abnormality in function or anatomy. Nephrectotny may very rarely be indicated for progressive bleeding from major renal disruption.
Non-specific infections. This is the condition of chronic recurrent pye-lonephritis which results from recurrent acute attacks of urinary infection leading to ultimate destruction of the renal substance. The place of surgery is usually ablative, the diseased organ being removed by nephrectomy if the contralateral kidney is normal.
Tuberculous infections. Tuberculosis of the kidney arises as a blood- borne infection leading to the development of multiple abscesses in the renal substances.
Treatment is primarily the administration of the anti- tuberculous drugs: streptomycin 1-0 g daily for three months coupled with 1NAH (Isoniazid) 100 mg t.d.s. and PAS (para-amino-salicylic acid) 16-0 g daily for two years (see p. 206). Surgical treatment of renal tuber¬culosis is confined to removing the hopelessly destroyed kidney, drainage of localized abscesses in the renal substance, cavernous, and correcting obstruction from fibrosis and stricture which may occur in the healing stage of the disease.
Congenital anomalies. Mistakes in development, such as the absence or reduplication of a kidney or ureter, or the fusion of the two kidneys at their lower poles (horseshoe kidney) are not uncommon; these conditions are symptomless unless the malformation interferes with the drainage of urine and predisposes to urinary tract infections. The best defense the urinary tract has against infection is the normal flow of urine along it which flushes any pathogenic micro-organisms to the exterior; any tendency to stagnation invites infection to become established.
Occasionally the valvular mechanism at the lower end of the ureter is defective and allows urine to regurgitate from the bladder into the ureter and renal pelvis during parturition.This 'ureter reflux' may give rise to recurrent urinary tract infections, especially in children. Surgical correction of the abnormality may be required.
Trauma. The kidney may be contused or partially ruptured in an injury to the hack or lower chest. It is frequently difficult to distinguish renal ;njury ions other intra-abdominal damage but the patient is usually shocked and evidence of haematuria confirms the renal injury.
Treatment. General resuscitation treatment for shock is carried out. Intravenous pyelography is then performed to assess the extent of any damage. Surgical intervention is rarely necessary; with bed rest and general nursing care the haelliaturia gradually abates and the kidney ultimately heals with surprisingly little residual abnormality in function or anatomy. Nephrectotny may very rarely be indicated for progressive bleeding from major renal disruption.
Non-specific infections. This is the condition of chronic recurrent pye-lonephritis which results from recurrent acute attacks of urinary infection leading to ultimate destruction of the renal substance. The place of surgery is usually ablative, the diseased organ being removed by nephrectomy if the contralateral kidney is normal.
Tuberculous infections. Tuberculosis of the kidney arises as a blood- borne infection leading to the development of multiple abscesses in the renal substances.
Treatment is primarily the administration of the anti- tuberculous drugs: streptomycin 1-0 g daily for three months coupled with 1NAH (Isoniazid) 100 mg t.d.s. and PAS (para-amino-salicylic acid) 16-0 g daily for two years (see p. 206). Surgical treatment of renal tuber¬culosis is confined to removing the hopelessly destroyed kidney, drainage of localized abscesses in the renal substance, cavernous, and correcting obstruction from fibrosis and stricture which may occur in the healing stage of the disease.
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