An unusual variant of intrarenal refluxes in the renal sinus cyst

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The intrarenal reflux is caused by impaired emptying of the renal pelvis, that leads to increased intrarenal pressure. Increased pelvis pressure can be the result of a variety of states. The most common causes are acute upper urinary tract obstruction or overfilling of the pelvis during retrograde intrarenal surgery (RIRS) or retrograde pyelography. In rare cases, it is due to impaired neuromuscular tone of the upper urinary tract that leads to hyperkinetic state.

We have presented case with a 73-year-old patient with intrarenal reflux into the peripelvic renal cysts. Since no such cases were found in the literature, this observation is unique.

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作者简介

N. Grigoriev

“European Medical Center"

Email: grigna69@gmail.com

Ph.D., MD, professor, Chief, Urologic Clinic, Head of the Department of Urology of “EMC Medical School”

俄罗斯联邦, Moscow

L. Tikhonova

“European Medical Center"

编辑信件的主要联系方式.
Email: ltihonova@emcmos.ru

Ph.D., urologist, Urologic Clinic

俄罗斯联邦, Moscow

T. Kuznetcova

“European Medical Center"

Email: ltihonova@emcmos.ru

Head of the Department of X-ray Diagnostics

俄罗斯联邦, Moscow

参考

  1. Pytel A.Ya. Pelvic-renal reflux and their clinical significance. M. Medgiz. 1959. Russian (Пытель А.Я. Лоханочно-почечные рефлюксы и их клиническое значение. М. Медгиз. 1959).
  2. Tokas T., Herrmann T.R.W., Skolarikos A., Nagele U. Pressure matters: intrarenal pressures during normal and pathological conditions, and impact of increased values to renal physiology. World J Urol. 2019;37(1):125–131.
  3. Tokas T., Tzanaki E., Nagele U., Somani B.K. Role of Intrarenal Pressure in Modern Day Endourology (Mini-PCNL and Flexible URS): a Systematic Review of Literature. Curr Urol Rep. 2021;22(10):52.
  4. Amis E.S., Cronan J.J. The renal sinus: an imaging review and proposed nomenclature for sinus cysts. J Urol. 1988; 139(6):1151–59.
  5. Vela-Navarrete R.., Robledo A.G. Polycystic Disease of the Renal Sinus: Structural Characteristics. The Journal of Urology 1983;129(4): 700–703.
  6. Bisceglia M., Galliani C.A., Senger C., Stallone C., Sessa A. Renal cystic diseases: a review. Adv Anat Pathol. 2006;13(1):26–56.
  7. Nahm A., Ritz E. The renal sinus cyst – the great imitator. Nephrology Dialysis Transplantation. 2000;15(6):913–914.

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2. Fig. 1. Ultrasonogram of the left kidney (longitudinal scan through the pelvis and ureter). The cup-pelvic system is dilated

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3. Fig. 2. Ultrasonogram of the left kidney (longitudinal scan through the peripheral part of the organ). Renal sinus cysts

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4. Fig. 3. Computed tomography (coronary reconstruction), native phase. The cup-pelvic system on the left is dilated

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5. Fig. 4. Computed tomogram (axial section), arterial phase. Dilated pelvis and upper third of the ureter. The contrast of the parenchyma of the left kidney is slow

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6. Fig. 5. Computed tomography (coronary reconstruction), excretory phase of the 15th minute of the study. The dilated cups of the left kidney are contrasted (arrows)

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7. Fig. 6. Computed tomography (coronary reconstruction), excretory phase of the 60th minute of the study. The accumulation of contrast media outside the cup-pelvic system (arrows) is determined.

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8. Fig. 7. Computed tomography. Tumor conglomerate in the area of the lower third of the left ureter (arrow)

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9. Figure 8. Intraoperative radiograph during upper urinary tract stenting on the left. The shadow of the ureteral stent against the background of a contrasting calyx-pelvic system. Oval-shaped clusters of contrast medium with clear, even contours outside the cup-pelvic system are determined - contrasting perihelvical cysts (some outlined with a dotted line)

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