Body growth in early diagnosed vesicoureteric reflux

Body growth was studied in 32 subjects with vesicoureteric reflux (VUR), diagnosed following the prenatal finding of urinary tract dilatation, who had normal renal filtration function and who received antibacterial prophylaxis by the first few days of life. They were followed for 1–5 years (mean 2.3 years). Most had persistent VUR during the 1st year of life. Body growth performance was compared with that of 94 subjects with VUR diagnosed and treated by us after the neonatal period. During the follow-up period, none of the patients with prenatally detected VUR had a height Z score below –2, nor a weight-for-height index below 90%, and 1 had variations in height Z score ≥1. The difference in the percentage of patients with prenatally detected VUR (1/32) and those with VUR diagnosed and treated after the neonatal period (20/94) who had variations in height Z score ≥1 was significant (P=0.035). Patients with prenatally detected VUR and normal renal filtration function, given antibacterial prophylaxis by the first few days of life, have normal body growth, although VUR still persists. Received: 19 March 1998 / Revised: 10 February 1999 / Accepted: 10 February 1999     

彩色多普勒超声动态观察大鼠单侧肾积水

目的 :动态观察单侧肾积水对患肾血流动力学的影响并评估患肾功能。方法 :在单侧完全性梗阻的动物模型上 ,用彩色多普勒B超检测梗阻各时期肾血流多普勒参数的动态变化。结果 :积水肾肾血流阻力指数 (RI)值随梗阻时间延长而逐渐升高 ,积水肾肾盂容积 (V)、前后径 (APD)逐渐增大 ,肾皮质厚度 (RCT)逐渐变薄 ,与假手术组比较存在显著性差异 (P <0 .0 5 )。梗阻第 6周开始 ,肾动脉RI值增高明显 ,各组之间比较存在显著性差异 (P<0 .0 1)。梗阻第 6周肾内动脉、第 12周肾动脉血流信号无法检测出。结论 :肾血流动力学改变可反映积水肾的严重程度并可作为临床上评估肾功能的参考指标之一。     

Wilms' tumor in horseshoe kidney: presentation due to ureteropelvic junction obstruction.

Children with horseshoe kidney usually develop urinary tract symptoms and often require operative correction of the anomaly. The incidence of Wilms' tumor in horseshoe kidney is higher than that for the general population. We present the case of a child whose Wilms' tumor was diagnosed early because of ureteropelvic junction obstruction secondary to a horseshoe kidney. A high index of suspicion should be maintained for Wilms' tumor in any child with a horseshoe kidney.     

PELVIURETERIC OBSTRUCTION IN CHILDREN: CONVENTIONAL PYELOPLASTY IS SUPERIOR TO ENDO-UROLOGY

Background : Hydronephrosis secondary to periureteric junction (PUJ) obstruction is common in infancy and childhood. Pyeloplasty has until recently been the accepted method of management, but alternative endo-urological techniques have evolved in the last decade. Methods : Published results of conventional pyeloplasty for primary PUJ obstruction in children were compared with published results of endo-urological procedures. Results : Sixty-six pyeloplasties were performed in 61 children in a 6-year period. During a similar period, 63 primary endo-urological procedures were reported in the literature. The success rate after pyeloplasty was 95.5% compared with 65% after endo-urology. Conclusions : Conventional pyeloplasty is superior to endo-urology and should remain the gold standard for the treatment of primary PUJ obstruction in children.     

离断式肾盂成形术治疗肾盂输尿管连接部狭窄16例

目的:探讨肾盂输尿管连接部狭窄(uretero pelvic junction obstruction,UPJO)的手术治疗方法。方法:采用Anderson-Hynes离断式肾盂成形术治疗UPJO16例。结果:16例手术均获成功,肾盂积水好转,狭窄解除,吻合口通畅。随访6个月,未出现吻合口再狭窄、肾积水加重等并发症。结论:Anderson-Hynes离断式肾盂成形术是治疗UPJO的首选术式。     

Rupture of the renal pelvis of a ureteropelvic junction hydronephrosis after blunt abdominal trauma

In the present case report, we present the unusual occurrence of traumatic rupture of a ureteropelvic junction hydronephrosis, and discuss the potential mechanisms producing such a rupture and the management options.     

A 5‐year audit of 778 neonatal renal scans (Part 2). Miscellaneous anomalies in 59 infants: A pictorial presentation

In this 5‐year review of 778 neonatal renal scans seen in an obstetric hospital, Mercy Hospital for Women, Melbourne, most infants were referred because of antenatal ultrasound findings. Ninety‐two percent of these had fetal pyelectasis. The results were classified on the ultrasound findings. The majority of neonates (76%) had a normal postnatal scan. A number had vesicoureteric reflux found on micturating cystourethrogram. Persisting mild/moderate pyelectasis or hydronephrosis (15%) proved to be a normal variant in many infants, but had a similar appearance to those with an early obstructive cause (1%). There were 59 infants (8%) with a miscellaneous group of renal anomalies, many with a characteristic antenatal ultrasound appearance suggesting the diagnosis. Review of these 59 infants illustrates the anomalies seen and reports the associated investigations and subsequent outcome in most cases.     

46例功能性肾盂输尿管交界处梗阻的外科治疗

本文总结了功能性肾盂输尿管交界处梗阻 (UPJO)病人 4 6例共 4 8只积水肾的诊疗资料 ,结合复习有关文献 ,指出 度积水肾可暂时观察 , 、 度积水肾以离断性肾盂成形术 (A-H)为佳 , 度积水肾的切除指征应严格掌握。指出了双“丁”内支架导管在 A- H手术中明显优于外支架导管 ,内支架应用组的手术成功率高于外支架组 ,泌尿系感染在内支架组中明显降低