What Is the Renal Pelvis?

It is a funnel-shaped flat sac combined with a large kidney. It is located in the renal sinus and migrates to the ureter after exiting the renal hilum. Adult renal pelvis has a volume of about 3 to 10 ml (average 7.5 ml). Retrograde urinary tract infections can easily cause inflammation, pus storage, and even pyelonephritis in the area; more kidney stones accumulate there. Its surface projection is located at the angle formed by the 12th rib and the outer edge of the iliac spine muscle (erector spinae). The patient can have tenderness or throbbing pain in this part.

It is a funnel-shaped flat sac combined with a large kidney. It is located in the renal sinus and migrates to the ureter after exiting the renal hilum. Adult renal pelvis has a volume of about 3 to 10 ml (average 7.5 ml). Retrograde urinary tract infections can easily cause inflammation, pus storage, and even pyelonephritis in the area; more kidney stones accumulate there. Its surface projection is located at the angle formed by the 12th rib and the outer edge of the iliac spine muscle (erector spinae). The patient can have tenderness or throbbing pain in this part.

Chinese name

Renal pelvis

Foreign name

Renal Pelvis

Belongs to

kidney

Shape

Conical sac

1 Renal pelvis 1. Renal pelvis cancer:

Renal pelvic carcinoma refers to a tumor that develops from the mucosa of the renal pelvis or calyces. Most of them are transitional cell carcinoma, accounting for about 8% of renal tumors. The age of onset is mostly over 40 years.

Pelvic pathology:

1. Papilloma is confined to the mucosa without submucosal infiltration. The diameter is between 1 and 5 cm, and it is a papillary or villous papillary protrusion. It is composed of transitional epithelium that is covered with fine branched connective tissue capillary bundles and is a benign tumor.

2. Papillary carcinoma is a malignant tumor derived from the transitional epithelium of the renal pelvis mucosa. Most of them are malignant from benign papilloma. The tumor is papillary or cauliflower-like. Microscopically, the tumor was centered on a thin fibrous blood vessel bundle, which was arranged in branches, and was covered with undifferentiated polymorphic transitional epithelium.

3. Squamous epithelial carcinoma tumors have flattened bumps, hard texture, and often spread to form ulcers in the renal pelvis, often accompanied by calcification and infection.

4. Adenocarcinoma consists of highly columnar, mucus-secreting cells forming acinar structures, and there are hyperplasia of smooth muscles around the acinus.

Key points of pelvis diagnosis:

I. Clinical manifestations

1. 90% of patients with hematuria found painless hematuria with the naked eye or microscope. Hematuria is the main cause of treatment, often gross hematuria, intermittent episodes.

2. Blunt pain in lumbar area and lump in one third of cases. During hematuria, clots of the ureter can cause renal colic, and tumors cause hydronephrosis and lumbar pain and discomfort. At the time of examination, the waist was full, and even a lump in the abdomen could be felt.

3. Tumor metastasis: Renal pelvis tumors can occur in early metastases, sometimes on the clavicle and enlarged lymph nodes.

Laboratory inspection

Urine shedding cytology can sometimes find tumor cells.

Third, imaging examination

1. B-ultrasound showed a medium echo area in the hyperechoic area of the renal pelvis and calamus, with irregular edges and small echo points inside.

2. X-ray examination, including excretory urography and retrograde angiography, is the main method for diagnosis of renal pelvic tumors. Visible filling defect in the pelvis, but it needs to be distinguished from blood clots in the pelvis.

3. When the tumor is small on CT, it is often difficult to show the tumor, but only changes such as secondary hydronephrosis. When the tumor is large, there is no pedicled mass in the renal pelvis or pylorus, and the CT value is 40 to 70 Hu. When a tumor invades the renal parenchyma, it is difficult to distinguish it from kidney cancer.

4. The diagnostic value of MRI for renal pelvic tumors is the same as CT, and the staging is more accurate than CT.

Fourth, endoscopic examination

1. Cystoscopic pelvic tumors are mostly transitional cell carcinoma, sometimes with bladder cancer, so cystoscopy should be routinely performed to exclude bladder cancer. Cystoscopy can also be performed retrograde angiography and renal pelvic urine for routine urine and exfoliated cell examination.

2. Ureter pyeloscope can look directly at the tumor, and can take biopsy to confirm the diagnosis.

Principle of pelvis treatment:

Radical resection of pelvic tumors is the only effective treatment. Once diagnosed and excluded from metastasis, if the contralateral kidney is healthy, a radical resection can be performed. The scope of the resection included the affected kidney, perirenal fat, fascia and hilar lymph nodes, the entire ureter and part of the bladder wall at the ureteral bladder opening. Postoperative chemotherapy, follow-up and review should be performed according to bladder tumors.