1. CONGENITAL ANOMALIES OF UT
Anomaly (anamalos-an exceptional), is a congenital deviation from the normal
structure and function), expressed in varying degrees.
Reasons: teratogenic factors in the early period of pregnancy, radiation,
medication, viral disease.
2. Classification (Lopatkin)
I. Abnormalities of the renal vessels.
Anomalies of the arteries.
1. Anomalies of the number and status of renal arteries:
a) incremental renal artery;
b) double renal artery;
c) multiple artery (multiple arteries).
2. Anomalies of the form and structure of arterial wall:
a) renal artery aneurysm (single and double sided);
b) fibromusculus renal artery stenosis. (fibromuscular).
3. Congenital arteriovenous fistula.
4. Congenital changes in renal vein:
a) anomalies of the right renal vein (multiple veins, a fall of vein of the
testis in the renal vein at right);
b) anomaly of the left renal vein (annular the left renal vein, retroaortal
the left renal vein, extracaval fall of the left renal vein).
3. II. Anomalies of the number of kidneys:
a) aplasia;
b) double kidney - complete and incomplete;
c) plus, the third kidney.
III. Anomalies of the kidney size of the renal hypoplasia (rudimentary, dwarf
kidney).
IV. Anomalies of locations and shapes of the kidneys.
1. Dystopy of kidneys:
a) single-sided (thoracic, lumbar, iliac, pelvic);
b) crossed
2. Fusion of the kidney:
a) unilateral (I - shaped kidney);
b) bilateral (symmetric - horseshoes; asymmetrical - L - and S - shaped
kidneys).
4. V. Anomalies of the structure of the kidney:
1. Dysplasia of kidney.
2. Multycystic kidney.
3. Polycystic kidneys:
a) polycystic kidney in adults;
b) polycystic kidney in childhood
4.Solitary renal cysts:
a) simple;
b) dermoid.
5. Peripelvic cyst.
6. Medullary anomalies:
a) Megacalix, polimegacalix;
b) sponge kidney.
VI. Combined renal abnormalities:
a) with vesicoureteral reflux (VUR);
b) with infravesical obstruction (IVO);
c) with VUR and IVO;
d) with anomalies of other organs and systems (sexual, musculoskeletal,
nervous, cardiovascular, digestive).
5. All defects can be divided into three groups: according to clinical signs:
lethal, leading to the death of during the first hours, days, rarely months of life;
constantly manifested by pain, dysuric phenomena and various complications -
inflammation, formation of stones, hydronephrosis, pathological reflux;
incidental clinical or postmortem findings.
Defects of the urinary system can be single or in
complexes of multiple congenital defects. Many of them are common in
chromosomal and genetic syndromes.
6. Anomalies of kidneys number
Aplasia (agenesis) - congenital absence of one kidney and renal vessels
(fig.4.1).
Reasons: complete disorder of nephrogenic differen-tiation, disorder of
development after the formation of the pronephros and mesonephros.
Bilateral agenesis (arenya) - lethal defect, in which the ureters, bladder and
urethra are abs.
Fig. 4.1.Translumbal aortogramm. Aplasia of the left kidney: a –arteriographicphase; b – nephrographic phase.
7. Duplication of kidneys combine with a doubling of the ureters.
4.2. Bilateral duplication of kidney.
8. Retrograde pielogram .A-full duplication of pelvis and ureters from two sides.
B - double-sided retrograde pielogram..A duplication of the pelvis and ureters
from two sides.Right full duplication of the ureter ureter duplex, left
incomplete - ureter fissus.
10. Anomalies of size
Excretory urogramma, and – a hypoplasia of the right
kidney, b – a retrograde left-side piyelogramma.
11. Anomalies of locations and shapes of the kidneys
Anomalies of kidneys locatıon, (A – dystopia and B – one-
unilateral dystopia): 1 – norm; 2 – chest; 3 – lumbar; 4 – iliac;
5 – pelvic thoracic.
13. Anomalies of fusion of the kidney ıs characterized by the fusion of two
kidneys in one organ. The two kidneys are grown together among themselves
and, depending on their form are it is distinguished: horseshoe, L-and S -
shaped kidneys.
Anomalies of the form of kidney: 1 - horseshoe; 2- «L» -
shaped; 3- «S»- shaped; 4 - Biscuit-shaped
