Horseshoe kidney is a congenital developmental defect in which both kidneys are fused together at the upper or lower border, forming a isthmus. The pathology may be asymptomatic; however, approximately one-third of patients with this diagnosis develop concomitant kidney diseases or complications from other internal organs. Treatment of horseshoe kidney in Israel is prescribed based on indications and includes drug therapy using the latest medications and minimally invasive surgical methods. Timely completion of a full therapeutic course eliminates painful symptoms and ensures a positive prognosis in more than 95-97% of patients.
In Israeli medical centers, great attention is paid to the operational conduct of accurate diagnostics of the disease, which is carried out to make decisions regarding the necessity of prescribing a treatment course and selecting methods that are most effective for the patient. Conducting examinations on high-precision diagnostic equipment allows for the identification of pathology, description of characteristic features of the structure and functional activity of the examined organ, and assessment of the patient's overall condition. Patient reviews confirm the high effectiveness of the treatment provided, emphasize its acceptable cost, and comfortable conditions of stay in the hospital.
Methods of Treating the Disease
Horseshoe kidney is found in approximately 1 in 500 newborns, occurring in boys several times more often than in girls. The causes of the pathology lie in the disruption of the secondary kidney's movement to the lumbar region during embryonic development. The pathology is often associated with congenital anomalies such as hydrocephalus, polycystic kidney disease, and skeletal structure defects.
In most cases, the lower poles of the kidneys are fused, with dystopia being the most frequently diagnosed condition — the horseshoe kidney is located below normal anatomical boundaries. Excessively sharp movements can compress blood vessels and nerves, resulting in pain for the patient. It is noted that each of the fused kidneys has a separate ureter that drains into the bladder, along with a network of blood vessels. In almost 90% of patients, the circulation and structure of the calyx system of the horseshoe kidney differ from the norm.
In the presence of pathology, the patient experiences a characteristic pain syndrome: pain is felt in the area of the navel (occurs when bending the torso), lower back, and lower abdomen. Compression of the nerve endings of the mesentery by the isthmus leads to constipation, intestinal spasms, and impaired peristalsis. Prolonged pain can cause the patient to develop hysteria, neurasthenia, and other psycho-emotional disorders. Compression of blood vessels causes increased venous intrarenal pressure, leading to hematuria. Stagnation in the veins also contributes to the development of varicose veins in the pelvic area and legs, as well as swelling of the lower extremities.
As complications, many patients develop various types of kidney diseases: hydronephrosis, urolithiasis, pyelonephritis. Arterial hypertension also frequently arises on this basis. In recent years, an increasing number of researchers have concluded that the cells of the isthmus of the horseshoe kidney are prone to malignant degeneration, resulting in kidney tumours.
If there are no clinical symptoms of the pathology, specific treatment is replaced by constant monitoring by a urologist and regular comprehensive examinations aimed at the timely detection of developed complications. In the diagnosis of pyelonephritis, a course of symptomatic drug therapy is prescribed. If necessary, the following minimally invasive surgical methods are included in the treatment course:
- division of the isthmus and fixation of the kidneys in the normal position — indicated in cases of severe pain and urinary dynamics disturbances;
- heminephrectomy — if one half of the horseshoe kidney is affected and its functional activity is irreversibly suppressed, it is removed using minimally invasive laparoscopic surgery;
- percutaneous lithotripsy — a method of laser fragmentation of kidney stones, where access to the pathological focus is obtained through a small incision, into which an endoscope equipped with channels for conducting a laser beam is inserted;
- pyelolithotomy — removal of stones localized in the renal pelvis by incision, indicated for large calculi and ineffectiveness of stone fragmentation by other methods;
- percutaneous nephrolithotomy — the most common method in Israel for removing large stones, performed under general anesthesia, involves puncturing the kidney with a special needle, through which a guide is introduced, allowing further access to the pathological focus with a nephroscope, which accurately determines the location of the calculi. Stones are fragmented using a lithotripter and removed through the nephroscope's lumen.
Methods of Diagnosing the Disease
To make the right decision regarding the necessity of treatment, as well as to construct a therapy scheme if necessary, the patient must undergo a comprehensive examination, which takes about three days in Israeli clinics.
At the initial consultation with the leading urologist, to whom the patient is referred immediately after arriving at the medical center, the doctor reviews the medical history and results of earlier studies, conducts an interview with the patient's parents, clarifying the presence of characteristic symptoms. After a superficial examination, the urologist compiles a list of necessary examinations.
Performing the diagnostic procedures prescribed by the attending physician:
- laboratory tests of urine (including bacterial culture) and blood;
- ultrasound examination (US) of the kidneys;
- ultrasound Dopplerography (USDG) — a method for detecting blood flow disturbances in the renal vessels;
- excretory urography — a radiological examination of the kidneys that allows determining the structural features of the urinary system organs;
- retrograde pyelography — an invasive radiographic examination of the kidneys and urinary tract, where a ureteral catheter is used to introduce a contrast agent;
- nephroscintigraphy — a method for assessing the structural composition and functional activity of the kidneys;
- renal angiography — intended for studying renal vessels.
The results of the studies are submitted for review by a medical council, which includes a urologist and specialized specialists. After analyzing the obtained data, the doctors collectively make a final diagnosis and prescribe treatment.
Advantages of Treatment in Israel
- High level of physician qualifications.
- Modern material and technical base.
- Professional performance of minimally invasive surgical procedures.
- Quick and accurate diagnostics.
- Affordable prices.
To avoid the development of serious complications, it is necessary to undergo comprehensive diagnostics and required therapy in a timely manner. By contacting an Israeli clinic, you can quickly learn the exact diagnosis and, if necessary, receive treatment from highly qualified specialists.