From the Guidelines
Renal pelvic fullness is a condition that requires prompt evaluation to determine the underlying cause, and treatment should be guided by the severity of symptoms and the presence of any underlying obstruction, as indicated by studies such as 1 and 1.
Causes and Evaluation
Renal pelvic fullness refers to dilation of the collecting system in the kidney, specifically the renal pelvis. This condition is often an incidental finding on imaging studies and may not require treatment if mild and asymptomatic. Common causes include partial urinary obstruction from kidney stones, ureteropelvic junction obstruction, pregnancy, vesicoureteral reflux, or simply overhydration at the time of imaging.
- The condition can be classified based on the cause and the presence of unilateral or bilateral involvement, as noted in 1.
- Obstructive hydronephrosis can be further classified by the level of obstruction, complete versus partial obstruction, and intrinsic versus extrinsic obstruction, as discussed in 1.
Management and Treatment
If the fullness is caused by obstruction, intervention may be necessary to prevent kidney damage. This could involve procedures to remove stones, repair structural abnormalities, or place stents to improve urine flow.
- Monitoring with follow-up ultrasounds is often recommended to ensure the condition doesn't worsen, as suggested by 1.
- Staying well-hydrated (but not excessively) and promptly treating urinary tract infections can help manage symptoms if present, as implied by the discussion on the importance of addressing underlying causes in 1.
- The significance of renal pelvic fullness varies widely - it can range from a normal variant to a sign of serious urological conditions, which is why professional evaluation is important, as emphasized in 1 and 1.
Diagnostic Imaging
CT urography (CTU) and CT abdomen and pelvis without IV contrast are imaging studies that can be used to evaluate renal pelvic fullness, as discussed in 1 and 1.
- CTU is tailored to improve visualization of both the upper and lower urinary tracts and can help identify the underlying cause of renal pelvic fullness, as noted in 1.
- CT abdomen and pelvis without IV contrast can be useful in evaluating symptomatic patients when US is inconclusive, as suggested by 1.
From the Research
Renal Pelvic Fullness
- Renal pelvic fullness can be a symptom of various conditions, including renal colic, pyelonephritis, and obstructive nephropathy.
- According to 2, renal colic is an acute syndrome involving unilateral flank pain, linked to an obstruction in the upper urinary tract, which may cause renal pelvic fullness.
- The study 3 mentions that acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney, which can also cause renal pelvic fullness.
- In the case of obstructive nephropathy, renal pelvic fullness can occur without hydronephrosis, as seen in the study 4, where a patient presented with severe acute kidney injury and mild prominence of the bilateral renal collecting systems without evidence of hydronephrosis.
- The management of renal pelvic fullness depends on the underlying cause, and may involve pain relief, antibiotic therapy, or surgical intervention, as discussed in the studies 2, 5, and 3.
- Imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), and renal ultrasound (US), can be used to diagnose and manage conditions causing renal pelvic fullness, as mentioned in the studies 5 and 4.
- The study 6 provides guidelines for the urological management of renal and ureteric stones in adults, which can also be relevant to the management of renal pelvic fullness caused by stones.