Recently, the Department of Upper Urology, 108 Central Military Hospital admitted a 49-year-old female patient ( Hanoi ) to the hospital with symptoms of prolonged hematuria and pain in the right lumbar region lasting more than 1 month, a history of bilateral congenital polycystic kidney disease discovered many years ago, end-stage chronic renal failure with dialysis twice a week.
The doctor examined and found a large, firm abdomen on both sides, the right side was larger, and the right side was painful to the touch, the patient was weak, had anemia, and a CT scan of the urinary system showed polycystic kidneys on both sides, with bleeding in the cyst on the right side, and a large kidney measuring 15 cm.
The kidney tumor was surgically removed by surgeons (photo source: 108 Central Hospital).
Cystoscopy showed red blood spurting from the right kidney, Dr. Tran Duc Dung, Department of Upper Urology said.
Doctors consulted with the urology department and the dialysis department: large right polycystic kidney with complications of prolonged hematuria causing blood loss, surgery was indicated.
The surgical team was led by Dr. Nguyen Viet Hai - Head of the Department of Upper Urology, representative of the surgical team Dr. Tran Duc Dung shared: "Because the polycystic kidney is large in size in an anemic patient, we used the abdominal route, controlled the renal vascular pedicle, limited bleeding and damage to surrounding organs.
Surgery time 60 minutes, no blood transfusion required after surgery, tumor size more than 30 cm, weight 2.8 kg".
After 7 days, the patient was stable, eating and living normally, and transferred to the department for periodic dialysis.
Evaluating the surgery, Dr. Dung said: “Removing a giant polycystic right kidney is a difficult surgery, requiring meticulousness, avoiding intestinal damage and limiting bleeding. Hemostasis during surgery is very important because after removing the kidney, it will be a large empty cavity, very susceptible to secondary bleeding when the patient is on dialysis on the second day after surgery.”
For patients with polycystic kidney disease, they should have regular health check-ups as scheduled by a nephrologist to control blood pressure, have a low-salt, low-protein diet, drink enough water, and take antibiotics when there is an infection. Especially consider a kidney transplant in the future, Dr. Tran Duc Dung recommends.
Polycystic kidney disease is a genetic disease, there are 2 types: recessive or dominant. Dominant genetic disease usually starts in middle age, while recessive disease usually starts in adolescence.
However, the disease usually begins in adults and clinical manifestations often appear after 30-40 years of age. It is very rare for the disease to begin in childhood.
Cystic kidney disease can be associated with liver cysts and cardiovascular abnormalities and often leads to end-stage renal failure. Therefore, understanding the disease and knowing how to prevent dangerous complications is extremely important. Diagnosis is based on abdominal ultrasound, CT Scan and MRI.
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