Calyceal Diverticula: What Are The Symptoms, Diagnosis and Treatment Options?

Calyceal diverticula is a term often heard in the context of kidney health, but many people may not fully understand what it means or how it can impact their well-being. In this article, we will look deep into calyceal diverticula, trying to know what they are, their symptoms, how they are diagnosed, and the various treatment options available. Whether you are a healthcare professional or someone interested in learning more about kidney conditions, this article aims to provide valuable information on the topic.

What Are Calyceal Diverticula?

Calyceal diverticula, also known as caliceal diverticula, are small sac like structures or pockets that can form within the kidney. They typically develop in one or more of the renal calyces which are part of the kidney’s collecting system. To better understand what calyceal diverticula are, let’s break down the terminology:

Calyceal: This refers to the renal calyces which are cup like structures in the kidney that collect urine.
Diverticula: These are small pouch like structures that can develop in various parts of the body, which are often associated with the gastrointestinal tract.

In the case of calyceal diverticula, these pouch like structures form within the calyces of the kidney, creating pockets where urine can accumulate. It is important to note that calyceal diverticula are generally considered a benign condition, meaning they are not cancerous. However, they can cause discomfort and other symptoms which we will discuss in detail.

Symptoms of Calyceal Diverticula

Calyceal diverticula may not always cause noticeable symptoms and they are sometimes discovered incidentally during medical imaging tests. However, when symptoms do occur, they can vary in intensity and may include:

Flank Pain: One of the most common symptoms associated with calyceal diverticula is flank pain, which can range from mild discomfort to severe pain. This pain is often felt on the side or back where the affected kidney is located.
Urinary Tract Infections (UTIs): Some individuals with calyceal diverticula may experience recurrent UTIs. The pockets created by the diverticula can trap urine and create an environment where bacteria can thrive, which increases the risk of infections.
Hematuria: Hematuria refers to the presence of blood in the urine. It can be visible (gross hematuria) or only detectable under a microscope (microscopic hematuria). Blood in the urine can be a concerning symptom that should be evaluated by a healthcare provider.
Frequent Urination: In some cases, individuals with calyceal diverticula may experience an increased frequency of urination. This can be a result of irritation or pressure on the bladder caused by the diverticula.
Flank Mass: In rare instances, a palpable mass or lump may be felt in the flank area, indicating the presence of a calyceal diverticulum.

Diagnosis of Calyceal Diverticula

Diagnosing calyceal diverticula typically involves a combination of medical history assessment, physical examination, and imaging studies. Here’s how the diagnosis process may be:

Medical History and Physical Examination: Your healthcare provider will start by taking a detailed medical history and performing a physical examination. They will inquire about your symptoms and any previous kidney related issues.
Imaging Studies: Imaging tests are important for confirming the presence of calyceal diverticula. Common imaging modalities used for this purpose include:

Ultrasound: A non-invasive imaging technique that uses sound waves to create images of the kidneys. Calyceal diverticula may appear as fluid filled sacs on ultrasound images.
CT Scan: Computed Tomography (CT) scans provide detailed cross-sectional images of the kidneys and can help identify the diverticula.
Intravenous Pyelogram (IVP): This is a specialized X-ray procedure where a contrast dye is injected into a vein to visualize the urinary tract. IVP can help identify the structure and function of the kidneys, including the presence of diverticula.

Cystoscopy: In some cases, a cystoscopy may be performed. During this procedure, a thin, flexible tube with a camera on the end (cystoscope) is inserted through the urethra to examine the bladder and ureters. While this procedure primarily focuses on the lower urinary tract, it can sometimes provide additional information about the upper urinary tract, including calyceal diverticula.

Treatment Options for Calyceal Diverticula

The approach to treating calyceal diverticula depends on several factors including the severity of symptoms, the size and location of the diverticula, and the health of the individual. Treatment options may include:

Observation: If calyceal diverticula are small and asymptomatic, a “watch and wait” approach may be recommended. Regular follow up with imaging studies can monitor any changes in size or symptoms.
Percutaneous Drainage: In cases where diverticula are causing significant discomfort or recurrent infections, a minimally invasive procedure known as percutaneous drainage may be considered. This involves the insertion of a thin needle or tube through the skin and into the diverticulum to drain urine and relieve pressure.
Laparoscopic Surgery: Surgical removal of the diverticulum may be necessary for larger or more troublesome diverticula. Laparoscopic surgery is a minimally invasive approach that involves small incisions and the use of specialized instruments for removal.
Open Surgery: In rare and complex cases, open surgery may be required. This involves a larger incision and a more extensive procedure to remove the diverticulum.
Antibiotics: Antibiotics are often prescribed to manage and prevent urinary tract infections associated with calyceal diverticula.

Takeaway

Calyceal diverticula, although benign, can have a significant impact on an individual’s quality of life when they cause symptoms. It is essential to recognize the signs and seek medical advice if you experience flank pain, recurrent UTIs, hematuria, or other urinary symptoms.

Diagnosis typically involves a combination of medical history assessment, physical examination, and imaging studies, such as ultrasound or CT scans. Treatment options may be from observation to minimally invasive procedures and, in rare cases, open surgery.

If you suspect that you may have calyceal diverticula or are experiencing related symptoms, it is important to consult a healthcare provider for a proper evaluation and personalized treatment plan. Early diagnosis and management can help alleviate discomfort and reduce the risk of complications associated with this condition.