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Anomalies of Genito-Urinary Tract PowerPoint Presentation

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This medical PowerPoint presentation is about the anomalies of genito-urinary tract. There are several types of anomalies that can occur in the genito-urinary tract, which includes the kidneys, ureters, bladder, urethra, and genitals. Some of the most common anomalies are Hydronephrosis, Vesicoureteral reflux (VUR), Renal agenesis, Cryptorchidism, Hypospadias, Bladder exstrophy, Polycystic kidney disease (PKD), Urethral stricture, Epispadias and Wilms tumor.

Tags : Anomalies of Genito-Urinary Tract, kidneys, ureters, bladder, urethra, genitals, Hydronephrosis, Vesicoureteral reflux, Renal agenesis, Cryptorchidism, Hypospadias, Bladder exstrophy, Polycystic kidney disease, Urethral stricture, Epispadias, Wilms tumor

Published on : Jun 07, 2023 | Views : 1685 | Downloads : 1

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13.06.2023 Anomalies of Genito-urinary Tract 1 Anomalies of Genito-Urinary Tract Urology.
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13.06.2023 Anomalies of Genito-urinary Tract 2 Anomalies of genitourinary tract are the most wide-spread, since they are 40 % of all congenital developmental anomalies of person and 30 % of cases are combined with anomalies of genital and other organs. In accordance with the last data we observe growth of such patients number, that is explained by complicated development of genito-urinary system and impact of a good deal of unfavorable factors.
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13.06.2023 Anomalies of Genito-urinary Tract 3 Kidneys are formed of 2 primordiums: nephrogenic blastema and Wolfian duct.
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13.06.2023 Anomalies of Genito-urinary Tract 4 Nephrogenic blastema passes three stages of development: pronephros, initial kidney, final kidney and gives rise to glomuluses and one of tubules group.
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13.06.2023 Anomalies of Genito-urinary Tract 5 The other group of tubules, renal calices, pelvis, ureter, bladder, urethral canal are formed from Wolfian duct.
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13.06.2023 Anomalies of Genito-urinary Tract 6 Kidneys’ formation occurs on the 6-8 weeks of embryogenesis. That is why unfavorable factors’ impact - such as – radiological and nuclear, chemical, medicinal, thermal etc . in this period results in underdevelopment of these organs.
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13.06.2023 Anomalies of Genito-urinary Tract 7 It is worth mentioning that people with anomaly of genito-urinary organs may not even suspect, that they have a developmental anomaly.
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13.06.2023 Anomalies of Genito-urinary Tract 8 Anatomic features of improperly generated organs Disorder of urine passage Frequent development of retention diseases pyelonephritis hydronephrosis nephrolithiasis Renal insufficiency
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13.06.2023 Anomalies of Genito-urinary Tract 9 Anomalies in Number. Anomalies in Position. Fused kidneys Anomalies in Structure of Kidney Anomalies of kidneys:
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13.06.2023 Anomalies of Genito-urinary Tract 10 Anomalies in number: Aplasia (agenesia) Duplicated kidney Supernumerary kidney
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13.06.2023 Anomalies of Genito-urinary Tract 11 Aplasia of kidney is the result of halt of development on pronephros or initial kidney stage The following methods of examination help to make a correct diagnosis of aplasia:
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13.06.2023 Anomalies of Genito-urinary Tract 12 Aplasia of kidney The whole trigone of the bladder or the half may be absent. The ureteral orifice of anomalous kidney sometimes drains into genital tract and not into the bladder CYSTOSCOPY. Aplasia of the right kidney (absence of ureter orifice)
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13.06.2023 Anomalies of Genito-urinary Tract 13 Aplasia of kidney Excretory Urography. Aplasia of right kidney (absence of pelvis)
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13.06.2023 Anomalies of Genito-urinary Tract 14 Aplasia of the right kidney and compensatory hypertrophy of the left kidney. Aplasia of kidney CT image.
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13.06.2023 Anomalies of Genito-urinary Tract 15 Aplasia of kidney 25 % of observations of solitary ren note malformation of genital system, such as duplication of uterus or vagina, which are formed from Wolfian duct
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13.06.2023 Anomalies of Genito-urinary Tract 16 Treatment of congenital solitary kidney and its disease. A solitary kidney usually requires no treatment, but it is necessary in case ren’s affection by disease. Only organ-preserving operations are performed: pyelolithtomy, ureterolithtomy, nephropexy and plastic surgery on urinary tract.
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13.06.2023 Anomalies of Genito-urinary Tract 17 It is the third or even fourth separate additional kidney. A supernumerary kidney is rather a rare anomaly. Supernumerary kidney
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13.06.2023 Anomalies of Genito-urinary Tract 18 Each supernumerary kidney has its independent vascular pedicle and own ureter, opening into urinary bladder (independent orifice) or a branch of main ureter of normal (main) kidney (general orifice).
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13.06.2023 Anomalies of Genito-urinary Tract 19 The diagnosis is made on the basis of excretory urography or retrograde pyelography, when two pelvis are seen at a distance from one another and when there are two separate kidney images. Supernumerary kidney
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13.06.2023 Anomalies of Genito-urinary Tract 20 Supernumerary kidney Pneumoretroperitoneum provides with a clearer image of kidneys. Renal angiography will help in complicated cases before surgical interference These methods of examination make it possible to distinguish a supernumerary kidney from a duplicated kidney.
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13.06.2023 Anomalies of Genito-urinary Tract 21 The question of TREATMENT arises only in diseases of the supernumerary kidney. Nephrectomy is the operation of choice, since there is usually no need for organ-preserving operation. They are performed in cases of functional decrease of main rens. Supernumerary kidney
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13.06.2023 Anomalies of Genito-urinary Tract 22 Duplicated kidneys occur often enough: Duplication of kidneys can be defined due to extra urinary tracts in 10,4% of all urological patients
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13.06.2023 Anomalies of Genito-urinary Tract 23 Duplication of kidneys ureter orifice into urethra or genital organs. In such a way complete duplication (2 ureters with separate orifices), or incomplete duplication kidney and anomaly of ureter termination is formed. Pathological development goes by parallel formation of 2 ureter primordiums on Wolfian duct or splitting of 1 primordium into 2 branches. Shift of extra primordium to the side of urethra forming or to genital organs side results in ectopia of
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13.06.2023 Anomalies of Genito-urinary Tract 24 Duplicated kidneys are often accompanied with congenital ureteral defects: ectopia, ureterocele, blind ending of terminal or cranial ureteral segment, and stenosis of ureter or its valves
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13.06.2023 Anomalies of Genito-urinary Tract 25 Vascularization of the duplicated kidney may be provided by one Angiography. Duplication of kidneys or more renal arteries, which separate into branches and give separate terminal arteries to each of its parts.
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13.06.2023 Anomalies of Genito-urinary Tract 26 Cystoscopy An accessory ureteral orifice in the bladder is seen – complete duplication of the kidney. Duplication of kidneys
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13.06.2023 Anomalies of Genito-urinary Tract 27 Excretory urography makes recognition of the anomaly possible in most cases. Duplication of kidneys When the kidney is functioning well both pelvis and ureters are clearly visible as well as their morphological features and the function of each part;
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13.06.2023 Anomalies of Genito-urinary Tract 28 Conservative treatment spasmolytics and catheterization of renal pelvis, is aimed at improving urine flow from the upper urinary tract and relieving dyskinesia, is applied in cases when it causes pain. Treatment of duplicated kidney and their disease.
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13.06.2023 Anomalies of Genito-urinary Tract 29 is eliminated development of diseases associated with poor drainage of the pelvis Correction of disorders of urodynamics of upper urinary tract (dyskinesiaand interureteral yo-yo reflux) by organ-preserving operations: high-level pyeloureterostomy and remove one of ureters
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13.06.2023 Anomalies of Genito-urinary Tract 30 In mild or moderate grade I-II of hydronephrosis, when the kidney keeps on functioning, plastic procedures are performed: pyelopyelostomy or pyeloureterostomy or ureteroureterostomy. Duplication of kidneys
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13.06.2023 Anomalies of Genito-urinary Tract 31 Heminephrectomy is recommended in cases of gross destruction of ren reduced function of a ren’s part doubtful outcome of plastic operation
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13.06.2023 Anomalies of Genito-urinary Tract 32 It is preferable to use mechanical tantalum suture, applied by means of the УКЛ-60 stitcher.
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13.06.2023 Anomalies of Genito-urinary Tract 33 Duplication of kidneys and resection of accessory ureter with the ectopic orifice. Excretory urography. Good functioning of the operated kidney. A chain of tantalum staples is seen in the upper pole of the kidney. After an operation of heminephrectomy
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13.06.2023 Anomalies of Genito-urinary Tract 34 is the result of disorder of normal shift to ordinary bed in lumbar area. No turn around ren’s own axis occurs. Anomalies in Position. Kidney Distopia.
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13.06.2023 Anomalies of Genito-urinary Tract 35 Classification pelvic iliac lumbar thoracic homolateral heterolateral unilateral bilateral: symmetrical asymmetrical Anomalies in Position. Kidney Distopia.
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13.06.2023 Anomalies of Genito-urinary Tract 36 Kidney Distopia. Diagnosis Dystopic kidneys are predisposed to retention diseases: hydronephrosis nephrolithiasis pyelonephritis
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13.06.2023 Anomalies of Genito-urinary Tract 37 is diagnosed by: Kidney Distopia abdominal pain of indefinite localization or pain in lower abdomen, in some cases dysuric disorders, symptoms of diseases of female genitals, gastro-intestinal, nervous and cardiovascular system a tumor palpated in the abdomen
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13.06.2023 Anomalies of Genito-urinary Tract 38 Diagnosis X-ray methods of examination are the leading techniques in the diagnosis of dystopic kidneys.
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13.06.2023 Anomalies of Genito-urinary Tract 39 Diagnosis Excretory urography | Retrograde pyelography The lateral position of pelvis, median position of calyces and a short ureter are seen. Hydronephrosis of dystopic kidney
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13.06.2023 Anomalies of Genito-urinary Tract 40 Isotope renorgraphy | Kidney scintiscanning shows function of kidney and in some cases indicates the absence of function though the function is satisfactory (if the sensors are located on the place, that is to be occupied by normal kidney) Diagnosis
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13.06.2023 Anomalies of Genito-urinary Tract 41 Treatment of diseases of dystopic kidney. People with dystopic kidneys that have no clinical manifestations or diseases require no treatment.
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13.06.2023 Anomalies of Genito-urinary Tract 42 Surgery should be performed in all cases of hydronephrotic ren transformation concomitant infection disorders of renal function nephrolithiasis (frequent renal colic) Treatment of diseases of dystopic kidney.
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13.06.2023 Anomalies of Genito-urinary Tract 43 Fused Kidneys Anomalies of Interrelation are characterized by fusion of 2 renal primordiums during 8 week of embriogenesis into 1 organ, its ureteres ending in ordinary place. There are many variants of fusion according to form and relation to vertebra.
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13.06.2023 Anomalies of Genito-urinary Tract 44 Horseshore kidney fused at lower pole Cake kidney Horseshore kidney fused at upper pole
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13.06.2023 Anomalies of Genito-urinary Tract 45 Scheme of fused kidney vascularization Fusion occurs in lower poles in 90%. Isthmus can be parenchymatous or fibrous, Pelvis located on anterior surface. The fused ren can have 1-10 arteries, enveloping and fixing organ.
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13.06.2023 Anomalies of Genito-urinary Tract 46 X-ray methods of examination Excretory urography Retrograde pyelography
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13.06.2023 Anomalies of Genito-urinary Tract 47 Scintyscanning of horseshoe kidney.
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13.06.2023 Anomalies of Genito-urinary Tract 48 Preoperative renal angiography , determines many extra arteries (arterial phase ). Knowledge of vascularization of isthmus and distribution of vessels prevents dangerous bleeding. Shape and position of organ are determined in parenchymatous phase.
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13.06.2023 Anomalies of Genito-urinary Tract 49 Extraordinary anatomy favors urostasis in pre-pelvic part of ureteres and development of pyelonephritis, hydronephrosis, nephrolithisiasis.
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13.06.2023 Anomalies of Genito-urinary Tract 50 Surgical treatment of fused kidney. 2 groups can be distinguished: operations without transection of renal isthmus and -operations with transection or resection of isthmus of anomalous organ.
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13.06.2023 Anomalies of Genito-urinary Tract 51 Resections of isthmus and lower poles of horseshoe kidney result of operation. horseshoe kidney
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13.06.2023 Anomalies of Genito-urinary Tract 52 Simple cysts are divided into congenital (primary) and acquired (secondary) cyst. Is formed as a result of single lacks of coincidence of convoluted and straight renal tubules Is formed after infarct of ren, pyelonephritis, nephrolithiasis, (is a result of ischemia, inflammation, urostasis) Anomalies in Structure of Kidney. Cystic Diseases of the Kidneys
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13.06.2023 Anomalies of Genito-urinary Tract 53 Solitary cyst 1.is either round or oval in shape 2.The contents of the cyst usually serous, rarely haemorrhagic 3.may be localized in various parts of organ: 4.1-10 cm in diameter Subcapsule Intraparenchimatose Cortical Peripelvic Multilocular
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13.06.2023 Anomalies of Genito-urinary Tract 54 Solitary cyst usually has no specific symptoms Is found occasionally in urological examination Pains in lumbar Palpated tumor Total haematuria Arterial hypertension
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13.06.2023 Anomalies of Genito-urinary Tract 55 Complications of solitary cyst Hemorrage Disruption of cyst Suppuration Forming of concrements in pelvic-calicular system
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13.06.2023 Anomalies of Genito-urinary Tract 56 Percutaneous puncture of cysts of kidneys is an atraumatic method and often allows to refuse surgical intervention Puncture is carried out under local anaesthesia Large solitary cysts in renal pole allow to puncture under ultrasonic control, aspiration and injection of sclerosing solutions into its cavity (ethylic spirit). Is often accompanied by recidivations of cystic disease Treatment of solitary cyst Small cysts need no treatment
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13.06.2023 Anomalies of Genito-urinary Tract 57 Acquired secondary cysts occur in case of pyelonephritis, nephrosclerosis(a), tumors cystadenoma – (b) tuberculosis (c) of kidney hydrocalosis (d)
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13.06.2023 Anomalies of Genito-urinary Tract 58 Polycystic kidney disease is frequent inherited by autosomal dominant anomaly is always bilateral process It may appear in children, but is usually diagnosed in adult life.
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13.06.2023 Anomalies of Genito-urinary Tract 59 Polycystosis is characterized by substitution of 2 rens parenchyma by multiple cysts of various size. Defect occurs due to ill-timed conjugation of straight and convoluted tubules, formed from various primordiums in embriogenesis of secretory and excretory nephrone’s segments. I.e. urine drainage is violated, blindly closed tubules are dilatated and form cysts. If this tubules do not join at all, large cysts are formed.
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13.06.2023 Anomalies of Genito-urinary Tract 60 Squeeze of intertissue, urostasis lead to infection and pyelonephritis. Progressing of inflammatory process, increase of cyst size, disorder of renal function lead to renal insufficiency
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13.06.2023 Anomalies of Genito-urinary Tract 61 Polycystic kidneys are often combined with polycystic liver, pancreas, spleen, lungs, ovaries, and also with aneurysm of cerebral arteries etc.
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13.06.2023 Anomalies of Genito-urinary Tract 62 Polycystic kidney disease has various manifestations Dull pain in lumbar is the most common symptom due to: a) disturbed flow of urine; b) circulatory disorders in kidney; c) inflammatory processes in kidney. Pain in epigastrium may be caused by displacement of abdominal organs by large cystic kidneys and by considerably increased intraabdominal pressure.
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13.06.2023 Anomalies of Genito-urinary Tract 63 Palpable tumor in abdomen may be patient's only complaint. Polycystic kidney can be palpated by the patient himself due to large size and mobility. arterial pressure from 150/80 to 220/110 mm Hg in 20 per cent of cases cardiovascular disorders may be the only manifestation of polycystic kidneys Cardiovascular disorders are manifested by pain in the heart area, retrosternal pain, headache, and dizziness.
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13.06.2023 Anomalies of Genito-urinary Tract 64 3 stages in clinical course of polycystic renal disease: compensation, subcompensation, decompensation.
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13.06.2023 Anomalies of Genito-urinary Tract 65 Diagnostics of a polycystosis Scintigraphy of kidneys - to define quantity of functioning parenchyma Ultrasound research - many anechogenic zones in field of kidneys and liver CT scaning
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13.06.2023 Anomalies of Genito-urinary Tract 66 Treatment of polycystosisis difficult, since polycystic disease is a bilateral process, which tends to progress Non-operative treatment: complex measures: medicinal treatment dietetic therapy combined with physiotherapy elimination of infectious process in urinary tract and control of renal insufficiency, anaemia and hypertension aimed at:
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13.06.2023 Anomalies of Genito-urinary Tract 67 Operative treatment of polycystiс kidneys has temporary effect Indications: (1)persisting pain in renal area; (2) large cysts, particularly in region of renal hilus; (3) recurrent total haematuria; (4) suppuration of cysts; (5) hypertension resistant to hypotensive therаpy; (6) tumour or tuberculosis of polycystic kidney; (7) concrement in a kidney and ureter
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13.06.2023 Anomalies of Genito-urinary Tract 68 1. Surgical decompression of polycystic kidney by multiple punctures and emptying of cysts – ignipuncture (Rovsing’s operation) with omentorenopexia. 2. Percutaneous puncture of cysts under ultrasound control (operation of De La Pena).
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13.06.2023 Anomalies of Genito-urinary Tract 69 Thank You For Attention!