From the Research
Pelvocaliceal prominence refers to a mild dilation or enlargement of the renal collecting system, specifically the renal pelvis and calyces, which are structures within the kidney that collect urine before it flows into the ureter. This condition is often detected incidentally during imaging studies such as ultrasounds, CT scans, or MRIs. It may be physiological (normal variant) or pathological, potentially indicating partial obstruction of urine flow, vesicoureteral reflux, or other urinary tract abnormalities. Pelvocaliceal prominence is not necessarily a disease itself but can be a sign of underlying conditions. When detected, it typically requires clinical correlation and sometimes follow-up imaging to determine its significance. If the dilation is mild and the patient has no symptoms, no immediate treatment may be necessary. However, if it's associated with symptoms like flank pain, recurrent urinary tract infections, or hematuria, further evaluation by a urologist is warranted to identify and address any underlying cause. The prominence is assessed by measuring the anteroposterior diameter of the renal pelvis, with measurements under 10mm generally considered mild and potentially normal, especially during states of increased urine production or pregnancy, as noted in studies such as 1. According to the most recent study 2, ultrasound plays a primary role in the assessment and diagnosis of renal and ureteral pathologies, including pelvocaliceal prominence, and is considered the first-line imaging modality for evaluation of urinary obstruction and other indications. In terms of specific measurements, a study 1 found that optimal thresholds for detection of obstructive uropathy included a maximum anteroposterior diameter of the renal pelvis (mAPD) of ≥ 23 mm, which can help guide the assessment of pelvocaliceal prominence. Overall, the evaluation and management of pelvocaliceal prominence should prioritize the patient's symptoms, clinical correlation, and sometimes follow-up imaging, as supported by the evidence from studies such as 3, 4, 5.