Some aspects of diagnostics and treatment of pediatric patients with hydronophrosis

Abstract

Hydronephrosis is a progressive expansion of the pyelocaliceal system of kidney due to the urine outflow violation with the subsequent development of parenchymal atrophy.
Objective: to substantiate the peculiarities of surgical intervention and drainage on the basis of the analysis of causes of the urodynamic disturbances in the pyeloureteral segment.
Material and methods. In the clinic over the past three years, 153 children with severe hydronephrosis have been treated. The overwhelming majority were boys (99), more often left-sided hydronephrosis (up to 93 cases) occured. When analyzing the age characteristics, up to 3 years 79 children (51.6%) were treated, but a significant number of patients were also older children. The overwhelming majority of patients underwent Hynes-Anderson pyeloplasty.
Results and discussion. The question of the need for drainage was decided individually, depending upon the child’s age, the cause of obstruction and the peculiarities of congenital abnormalities in the anatomical structure of the pyelocaliceal system and ureter. Most often used pyeloureterostomy, stenting of the urinary tract. Nephrostomy was performed in connection with the renal pediculitis. Complications were observed in 5 children, which amounted up to 3.2%.
Conclusions. With the enlarged renal pelvis, which measures more than 30%, the coin-like deformity of the calyces was indicative for the operative intervention.
With congenital hydronephrosis in young children, the optimal age is 4–6 months. With hydronephrosis transformation of kidney, even with a reduced function, surgical treatment is necessary.