Urology


Kidney Diseases

As with all organs in our body, voiding function is also controlled by our nervous system. Neuro- urology is the unit undertaking diagnosis and treatment of patients with voiding dysfunction induced by spinal cord, brain, peripheral nervous system disorders.

Kidney is the organ that filters harmful substances in our blood. Kidney diseases are described below.

  • Nephritis

Inflammatory diseases of the kidney are called nephritis. This disease is one of the most important causes of kidney failure. It is divided into 2 as non- microbial and microbial nephritis.

  • Microbial nephritis (pyelonephritis)

It is also called as upper urinary tract infection. It is a disease mostly caused by bacteria and it shows a sudden onset. Viruses or fungi can rarely be the cause.

Symptoms of microbial nephritis are:

  • Fever
  • Sweating
  • Trembling
  • Chest pain
  • Painful urination
  • Frequent urination
  • Urgent need to urinate

The final diagnosis is made by urine culture. In patients with recurrent pyelonephritis, presence of an abnormality in the urinary tract should be investigated.

Recovery is achieved by antibiotic treatment. In case of an abscess, surgical intervention may be rarely needed. The kidney can be treated permanently and without damage to the kidney using a correct treatment. If it is not treated or in advanced cases, it may cause loss of the patient due to transfer of germs into the patient's blood.

  • Non- microbial Nephritis

It is a condition where inflammation occurs in glomerulus (the filter through which the blood coming to the kidney is filtered) or tubule (long, partly curved pipes in which the filtered blood is transformed into urine).

Symptoms of non-microbial nephritis are:

  • Frequent urination
  • Waking up at night to urinate
  • High blood pressure
  • Loss of salt, sugar, amino acids, protein with urine
  • Decline in production of vitamin D, and blood production hormone ( erythropoietin )
  • Anemia
  • deterioration in salt and water balance
  • Kidney failure.

In case of rapid progress of the condition, chronic renal failure occurs and the patient may need dialysis. Each patient is treated differently. Type of treatment is determined according to renal biopsy.

  • Albumin

It is a disease that occurs due to failure of urine filtration capsules in our kidney to work in full efficiency.

  • Kidney Stones

If inflammation of the urinary tract in a person results in a blockage, the substances in there precipitate and form kidney stones in our body. As a result, kidney stones cause severe pain and bleeding in our kidneys. Sometimes blood in urine has also been observed in this disease.

The majority of the stones up to 5 mm can be removed by drug therapy and intake of plenty of liquids. As the size of the stone increases, it is less likely to drop it without intervention.

ESWL ( Extracorporeal shock wave crushing ) is the most commonly used method in treatment of kidney stones. The shock waves generated outside the body are focused on the stone and the stone is crushed into small pieces during treatment. Then these pieces are expected to be discharged along with the urine.

Percutaneous nephrolithotripsy (PNL) is a current endoscopic surgery method applied when the stone inside the kidney is larger than 2 cm or couldn't be crushed by ESWL. Under general anesthesia, the kidney is entered by a tract created from an incision of 1 cm in the lumbar region and the stones are removed in the same way as a whole or by crushing them.

Another surgical treatment method is ureteroscopy. In this method, ureter is entered by urethroscope and the stones are crushed using laser. Advantage of ureteroscopy is that urethroscopes are flexible and thus even enter small pockets in the kidneys.

  • Uremia

Harmful substances carried to the kidneys by blood and excreted in the urine are called urea. Uremia is the illness occurring when urea is not excreted into the urine and is retained in the body. This illness results from failure of the kidney to adequately filter urea. The patient suffers from permanent headache, blurred vision, hiccups, a need for sleeping during the day, and insomnia during the night. It is a disease that should be treated immediately.

  • Kidney Cancer

Kidney cancer usually occurs between 50-70 years of age. It is 2-3 times more common in men than women. The cause of kidney cancer is not fully known yet. However, factors including smoking, genetic factors, hypertension, obesity, occupational risk factors (steel industry, petroleum, cadmium, lead industry employees) and exposure to radiation increases such risk.

Kidney cancers initially do not show any symptoms. However, as the tumor progresses, symptoms such as blood in urine, pain, loss of appetite, weight loss, recurrent fever, high blood pressure and anemia develop.

Surgery is the main treatment for renal tumors. Radiotherapy can be applied to support surgery.

  • Renal Failure:

It is divided into 2 groups as chronic and acute renal failure. This illness is a result of failure of kidneys in a person to fully perform their duties. Diagnosis of renal failure can be made by measuring urea and creatine levels in the blood.

The main functions of the kidneys are ensuring water, salt, calcium balance in the body, excretion of harmful substances and drugs from the body via urine and contributing to hormone, glucose metabolisms. In renal failure, these functions deteriorate. Kidney failure may develop in two ways, which are sudden (acute) or insidious (chronic).

The causes of acute renal failure include:

  • Heavy bleeding, vomiting, diarrhea, drop in blood pressure as a result of burns
  • Toxemia of pregnancy, abortions performed in unsanitary conditions
  • Heart failure
  • Kidney Diseases
  • Urinary obstruction:
  • Past surgeries
  • Drug-induced acute renal failure is a common problem so the drugs should be used strictly under doctor supervision.

The causes of chronic renal failure include:

  • Nephritis
  • Diabetes
  • Hypertension
  • Urinary tract diseases such as stones, obstruction , tumor
  • Renal cysts

Symptoms of renal failure can be listed as follows:

  • Getting up at night to urinate
  • Weakness , shortness of breath , palpitations
  • Reduction in the amount of urine,
  • Hypertension
  • Swelling in hands, feet and around the eyes