ABSTRACT
INTRODUCCIÓN: Las malformaciones congénitas urogenitales son diversas y pueden afectar las distintas estructuras que conforman el mencionado sistema. La importancia del diagnóstico oportuno de estas alteraciones radica en evitar un daño sobre el riñón pediátrico. El objetivo de este estudio fue identificar la frecuencia de las diferentes malformaciones urogenitales en pacientes pediátricos, en el Servicio de Pediatría del Hospital José Carrasco, durante el período enero 2014 diciembre 2018. MÉTODOS: Estudio descriptivo transversal, con un universo de 230 casos de niños con diagnóstico confirmado de malformación congénita urogenital confirmada, del Servicio de Pediatría del Hospital José Carrasco del IESS Cuenca, durante el período enero 2014 diciembre 2018. Se excluyeron 47 niños con registro médico incompleto. Se estudiaron en total 183 pacientes. RESULTADOS: La frecuencia de malformaciones urológicas fue 2.73% (n=183), con predominio en lactantes con el 56%, en el sexo masculino con el 57%. 26.78% de los pacientes presentaron clínica relacionada con infección de las vías urinarias. Se realizó ecografía al 95% de niños, uretrocistografía 55% y gammagrafía renal 31%. El hallazgo prenatal se hizo en el 34.97% de los casos. La malformación más frecuente fue la hidronefrosis transitoria 70%, seguida de reflujo Vesico-Ureteral (RVU) 16.39% (n=30), estenosis pieloureteral 5.46% (n=10), megauréter 6.55% (n=12) y displasia renal 1.63% (n=3). CONCLUSIÓN: Las malformaciones urológicas son comunes entre las malformaciones genéticas, la mayoría son asintomáticas; en nuestro medio debido a un bajo diagnóstico prenatal se detectan en los primeros 24 meses de vida. La hidronefrosis transitoria es la malformación más frecuente. La infección urinaria es el punto de partida en este grupo de pacientes; ante la sospecha de la malformación, la ecografía está indicada siempre.(au)
BACKGROUND: Congenital urinary tract abnormalities are diverse, and can affect different structures of this system. The importance of early diagnosis is avoiding kidney damage in the children. The aim of this study was to identify the frequency of urinary tract abnormalities in pediatric patients, in Hospital José Carrasco Arteaga Pediatric Surgery Department, from January 2014 to December 2018. METHODS: Descriptive cross-sectional study. The universe were 230 pediatric patients with confirmed diagnosis of congenital urinary tract abnormalities, from Hospital José Carrasco Arteaga Pediatric Surgery Department, from January 2014 to December 2018. Incomplete medical charts were excluded (n=47 children). 183 children were part of the this study. . La malformación más frecuente fue la hidronefrosis transitoria 70%, seguida de reflujo Vesico-Ureteral (RVU) 16.39% (n=30), estenosis pieloureteral 5.46% (n=10), megauréter 6.55% (n=12) y displasia renal 1.63% (n=3). RESULTS: The frequency of urological abnormalities was 2.73% (n = 183), predominately infants with 56%, and 57% male. 26.78% presented with symptoms related to urinary tract infection. Ultrasound was performed in 95% of the children, urethrocistography in 55% and renal scintigraphy in 31%. Prenatal findings were found in 34.97%. The most frequent abnormality was transient hydronephrosis (70%), followed up by vesico-ureteral reflux (VUR) 16.39% (n = 30), pyeloureteral stenosis 5.46% (n = 10), megaureter 6.55% (n = 12) and renal dysplasia 1.63% (n = 3). CONCLUSION: Urological malformations are common between genetic abnormalities, most of them are asymptomatic; locally due to the low rate of prenatal diagnosis, they are diagnosed in between 24 months of age. Transient hydronephrosis is the most frequent abnormality. Urinary tract infections are commonly the starting line in this groups of patients; when malformations are suspected, ultrasound is always suitable.(au)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Congenital Abnormalities , Urinary Tract , Urinary Tract Infections , Urogenital Abnormalities , Methods , DiagnosisABSTRACT
RESUMEN La extrofia vesical es una grave anomalía del desarrollo embriológico del seno urogenital y del sistema esquelético vecino. Se caracteriza por una falla de la pared anterior del abdomen y de la vejiga, cuya cara posterior-inferior, evertida hacia afuera, protruye en forma de hernia y exterioriza por completo el trígono, con los meatos ureterales eyaculando directamente hacia la pared abdominal; la asociación con epispadias es la regla. Se describió el caso de una paciente pediátrica con diagnóstico del complejo extrofia vesical-epispadias, entidad poco frecuente en nuestro medio, la cual evolucionó de manera favorable y se encuentra en espera de un segundo tiempo quirúrgico como parte de su tratamiento (AU).
ABSTRACT The bladder exstrophy is a serious anomaly of theurogenital sinus´ embryologic development and the close skeletal system, characterized by a failure of the abdomen anterior wall and bladder, whose posterior inferior face, turned outside out, protrudes like an hernia and completely exteriorizes the trigone, with the ureteral meatuses ejaculating right down to the abdominal wall; the association with epispadias is the rule. It was described the case of a pediatric patient with diagnosis of exstrophy- epispadias complex, infrequent entity in our country, who has evolved with great results and is waiting a second surgical time to finish her treatment (AU).
Subject(s)
Humans , Female , Infant, Newborn , Urogenital Abnormalities , Bladder Exstrophy , Epispadias , Surgical Procedures, Operative , Therapeutics , Urinary Diversion/methods , Child Health Services , Plastic Surgery Procedures/methods , Cuba , Abdominal WallABSTRACT
It is well known that infants born with imperforate anus have many other associated congenital anomalies, especially urogenital anomalies. Between 1985 and 1990, 50 infants and children with imperforate anus were evaluated for associated urogenital malformations according to the international classification on imperforate anus. The overall incidence of urogenital malformations in these patients was 28 percent. Among them, urogenital malformations were found in 50 percent of the patients with high or intermediate types of imperforate anus. Unilateral renal agenesis was the most frequently encountered urinary tract anomaly. In 10 cases, all of which were boys with high or intermediate types of imperforate anus, there was a fistulous connection between the blind end or the rectum and the urethra or bladder. The incidence of associated urogenital malformation was significant, especially in the high and intermediate types of imperforate anus. Therefore, we recommend that a careful examination should be done for the early diagnosis and treatment of associated urologic anomalies in infants and children with imperforate anus because considerable morbidity and mortality may occur due to delayed recognition of occult urologic problems in these infants.
Subject(s)
Child , Humans , Infant , Anal Canal , Anus, Imperforate , Classification , Early Diagnosis , Incidence , Mortality , Rectum , Urethra , Urinary Bladder , Urinary TractABSTRACT
The high incidence of genitourinary anomalies associated in patients with imperforate anus and rectum has long been recognized. The death of children suffering imperforate anus several years after satisfactory management of the alimentary lesion is often due fundamentally to oversight or poor management of a urologic lesion. We have recently two cases of imperforate anus associated with urogenital anomalies, urethrorectal and rectovaginal fistula.
Subject(s)
Child , Humans , Anus, Imperforate , Incidence , Rectovaginal Fistula , RectumABSTRACT
The high incidence of genitourinary anomalies associated in patients with imperforate anus and rectum has long been recognized. The death of children suffering imperforate anus several years after satisfactory management of the alimentary lesion is often due fundamentally to oversight or poor management of a urologic lesion. We have recently two cases of imperforate anus associated with urogenital anomalies, urethrorectal and rectovaginal fistula.