A RARE DISEASE COULD HAVE GONE UNNOTICED IF IT HADN’T BEEN FOR AN ACCIDENTAL INJURY

In one of Moscow’s suburbs, 9-year-old Artem (name changed) was hospitalized after an unfortunate fall from his bicycle. During examinations, specialists unexpectedly discovered serious kidney abnormalities: bilateral hydronephrosis, hypoplasia of the right kidney and a secondary shriveled left kidney. This rare condition could have gone undetected and continued to progress had it not been for an accidental injury.

Hydronephrosis is a congenital condition in which urine accumulates inside the kidneys, stretching and damaging their tissues. In this case, the cause of the outflow disorder was a congenital lack of muscular wall in the ureter, which prevented the normal passage of urine into the bladder.

Usually in such diseases children complain of abdominal or lower back pain, but Artem had no symptoms – his urine tests were always normal, and he had not had an ultrasound scan for a long time.

After the diagnosis, the boy’s family was recommended to get a consultation at the N.Lopatkin Research Institute of Urology and Interventional Radiology. Here Artem underwent additional examinations, the results of which showed that the function of the left kidney was practically lost, the organ was functioning at only 6%. The right kidney took over all the work on filtration of urine, compensating for the insufficiency of the left kidney. Specialists decided to perform an urgent surgical intervention to preserve the function of the right kidney.

The operation was performed using laparoscopic technique, which is the most gentle method, allowing to minimize trauma and reduce recovery time. Georgiy Vladimirovich Lagutin, a surgeon at the Children’s Department and Nikolay Vasilyevich Polyakov- head of the Reconstructive Urology Group at the N. Lopatkin Research Institute of Urology and Interventional Radiology, removed the narrowed section of the ureter, restored its patency, connected the renal pelvis with the healthy part of the organ, and installed a drainage system for the right kidney (nephrostomy) to prevent possible complications.

On the second day after the operation, Artem could already walk independently and felt well. According to Georgy Vladimirovich Lagutin, a researcher in the pediatric urology group, the prognosis in this situation is favorable: “We managed to perform the entire planned scope of the surgical intervention, and it is important that after such a complex treatment, our patient had no complications at this stage! Now it is important to monitor the function of the right kidney and control the dynamics of the left kidney. We are confident that Artem has every chance of preserving his kidney function.