Vestibular dilatation, also known as ectasia of the renal calyces or dilated kidney, is characterized by dilation of the inner portion of the kidney. This region is known as the renal pelvis, because it is shaped like a funnel and has the function of collecting the urine and taking it towards the ureters and the bladder, as the figure shows.
This dilatation usually occurs due to increased pressure in the urinary tract by blocking the passage of urine, which can be caused by dermities in the structures of the urinary tract, which is more common in children, or by situations such as stones, cysts, tumors or severe infection of the kidneys, and may also occur in adults. This change does not always cause symptoms, but pain in the abdomen or changes in urination may occur.
The pelvic floor dilation, which is also called hydronephrosis, can be diagnosed by imaging the region, such as ultrasound, which can demonstrate the degree of dilatation, the size of the kidney, and if its size causes compression of the tissues of the kidneys . Pyelocalyse dilatation on the right is usually more frequent, but it can also occur in the left kidney, or in both kidneys, being bilateral.
What are the causes
There are several causes for obstruction of the passage of urine through the pielocalicial system, and the main ones are:
The causes of pyelocalytic dilatation in the newborn are not well understood and, in most cases, tend to disappear after the baby is born. However, there are cases caused by anatomical deformities in the baby's urinary tract, which are more serious situations.
Adult pelvic floor dilation usually occurs as a consequence of cysts, calculi, nodules or cancer in the region of the kidneys or ureters, leading to blockage of urine passage and accumulation of urine, causing dilation of the renal pelvis. Check out more causes and how to identify in Hydronephrosis.
How to confirm
The pelvic floor dilation can be diagnosed by ultrasound examination or echography of the renal apparatus. In some cases, dilation can be detected in the baby still in the womb, on routine ultrasound examinations, but is usually confirmed after the baby is born.
Other exams that may be indicated for evaluations are excretory urography, urinary urethrography, or renal scintigraphy, for example, that may assess more details of urinary tract anatomy and flow of urine. Understand how it is made and the indications of excretory urography.
How is the treatment done?
Treatment for pelvic pain in a newborn depends on the size of the dilatation. When the dilation is less than 10 mm, the baby only needs to make several ultrasounds for the pediatrician to control its progression, since, normally, the dilation tends to disappear.
When the dilation is greater than 10 mm, the treatment is done with antibiotics prescribed by the pediatrician. In more severe cases, where the dilation is greater than 15 mm, surgery is recommended to correct the cause of the dilatation.
In the adult, the treatment of pelvic-anal dilation can be done with medications prescribed by the urologist or nephrologist, and surgery may be necessary, depending on the renal disease that caused the dilatation.
