The Rating System of Urodynamics Upper Urinary Tract in Children under Three Years Old with Congenital Hydronephrosis

Background. One of the main reasons for the incorrect differentiation of obstructive and non-obstructive disorders of the upper urinary tract (UUT) is age-related morphofunctional immaturity of the kidney and its structures in children of the first three years of life. Aims to investigate to determine the peculiarities of urodynamic disorders of the UUT in infants with congenital hydronephrosis using diuretic pyeloehography (DРG) method. Methods. There were studied DPG data of 55 patients aged 336 months with unilateral hydronephrosis of IIII grades SFU, which were divided into groups in accordance with the variant of violation of the urodynamics of the UUT (obstructive, obstructive-hypertensive and disadaptive). The variants established according to the parameters of the DPG (transient coefficient PUJ (Kpus), the coefficients of postfurosemide adaptation (Ka) and the efficiency of emptying (Ko) pelvis). The obtained data are compared with the conclusions of morphometric studies of the operated 20 children with ureteropelvic junction obstruction (UPJO). Results. The obstructive-hypertensive variant was determined in 18 patients, obstructive in 20, and disadaptive in 17. The severity of pelvic dysfunction (according to Ka and Ko) did not correlated to the grade of UPJO (according Kpus) in most cases. Intergroup and intragroup variability in the values of the DРG coefficients is confirmed by the results of PUJ and pelvis morphometry. The correlation between hystological modification in the pelvis and DPG parameters was revealed. Obtained data allowed to introduce a new indicator urodynamic indicator of quantitative assessment of functional insufficiency of the UUT. And the score gradation of each DРG coefficient (from 0 to 4 points) in accordance with deviation from the reference values was developed. The total indicator functional insufficiency is expressed by the sum of points (SP) for each coefficient (Ka, Ko, Kpus). When SP is less than 3 points light, 46 moderate, 79 expressed and 1012 severe grade of violation of urodynamics. The severity of dysfunctions of the UUT in 88% of children (n = 15) with a disadaptive variant corresponded to light degree, in 75% of patients (n = 14) with an obstructive-hypertensive variant expressed (50%) and severe (25%) grades. Moderate degree of dysfunction revealed in 65% of patients (n = 13) with an obstructive variant. Conclusion. The severity of urodynamic dysfunction of the UUT in this age group can be determined by the score gradation of the DPG parameters which reflects the functionality of the pelvis/PUJ and the grade of their violation adaptive reactions in response to diuretic.

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CHARACTERISTIC OF PEDIATRIC UROLITHIASIS PATIENTS IN ZAINOEL ABIDIN HOSPITAL

Indonesian Journal of Urology ◽

10.32421/juri.v25i1.322 ◽

2018 ◽

Vol 25 (1) ◽

Author(s):

Simon Natanel Yohanes ◽

Dahril Dahril

Keyword(s):

Urinary Tract ◽

Family History ◽

Lower Urinary Tract ◽

Pediatric Patients ◽

Upper Urinary Tract ◽

Stone Disease ◽

Age Group ◽

Pediatric Urolithiasis ◽

History Of ◽

Lower Urinary

Objective: We conducted a study to describe the characteristics of pediatric urolithiasis patients in Zainoel Abidin Hospital, Aceh-Indonesia. Material & Methods: Between January 2013 and March 2016, we retrospectively reviewed the medical records of 16 pediatric patients with urolithiasis in Zainoel Abidin Hospital, Aceh-Indonesia. The patients were come from whole Aceh region and the variables are sex, age, family history of stone disease, and stone location. The data were described in graphics and tables. Results: From 16 pediatric urolithiasis patients, 9 patients (56.3%) were males and 7 patients (43.7%) were females. In 2013 there were 4 pediatric urolithiasis patients (1.2%), in 2014 there were 5 (1.6%), and in 2015 there were 3 (2.3%). From January – March 2016 there were 4 pediatric urolithiasis patients (4.5% of all urolithiasis patients). The mean age of all pediatric patients were 7.7 ± 5.5 years (1-17 years). The incidence of urolithiasis for group < 5 years of age were 6 patients (37.5%) with mean age of 2 ± 1.14 years (1-4 years), in 5–10 years age group, there were 4 patients (25.0%) with mean age 7 ± 2.16 years (5-10 years), and 11–18 years age group, there were 6 patients (37.5%) with mean age 13.8 ± 2.16 years (12-16 years). Stones were located in the upper urinary tract in 9 cases (56.3%), lower urinary tract in 6 cases (37.5%), and combine stone located in upper and lower urinary tract in 1 case (6.2%). There were 5 patients (31.3%) with family history of stone disease. Conclusion: Pediatric urolithiasis case in Aceh Province is slightly predominant in male children, with mean age of 7.7 ± 5.5 years (1-16 years). The most common age group is evenly distribute between <5 years old and 11-18 years old. The most common stone location is in the upper urinary tract.

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Management of ureteropelvic junction obstruction associated with congenital upper urinary tract anomalies in children

Annals of Pediatric Surgery ◽

10.1097/01.xps.0000459979.60002.41 ◽

2015 ◽

Vol 11 (1) ◽

pp. 21-24

Author(s):

Osama M. Sarhan ◽

Abdulhakim A. Alotay ◽

Mustafa S. Alghanbar ◽

Ziad M. Nakshabandi

Keyword(s):

Urinary Tract ◽

Ureteropelvic Junction Obstruction ◽

Upper Urinary Tract ◽

Ureteropelvic Junction ◽

Urinary Tract Anomalies

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Exacerbation of Congenital Hydronephrosis as the First Presentation of COVID-19 Infection in Children: A Case Series

10.21203/rs.3.rs-920932/v1 ◽

2021 ◽

Author(s):

Masoumeh Mohkam ◽

Mahnaz Jamee ◽

Farshid Kompani ◽

Mitra Khalili ◽

Atena Seifi ◽

...

Keyword(s):

Urinary Tract ◽

Case Series ◽

Upper Urinary Tract ◽

Abrupt Increase ◽

Antenatal Hydronephrosis ◽

Congenital Hydronephrosis ◽

Abdominal Masses ◽

The Common ◽

Case Presentations

Abstract Background:Congenital hydronephrosis is one of the most common abnormalities of the upper urinary tract, which can be exacerbated by a variety of intrinsic or extrinsic triggers. The urinary tract system is one of the major organs complicated by COVID-19 infection. Case presentations:Here we report five patients with an established diagnosis of congenital hydronephrosis, who presented with acute abdominal pain and fever and an abrupt increase in the anteroposterior pelvic diameter (APD). Patients had a previous stable course and were under regular follow-up with serial ultra-sonographic studies. They underwent surgery or supportive treatment due to the later exacerbation of hydronephrosis. Based on the clinical and imaging findings, no plausible etiologies for these exacerbation episodes, including infection, nephrolithiasis or abdominal masses, could be postulated. The common aspect in all these patients was the evidence of a COVID-19 infection. Conclusions:Infection with COVID-19 in children with antenatal hydronephrosis may exacerbate the degree of hydronephrosis and renal APD in ultrasonography, which itself may be mediated by the increase in inflammatory mediators.

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Aging of the urogenital system

Reviews in Clinical Gerontology ◽

10.1017/s095925980001042x ◽

2000 ◽

Vol 10 (4) ◽

pp. 315-324

Author(s):

Carlos Verdejo Bravo

Keyword(s):

Urinary Tract ◽

Genital Tract ◽

Upper Urinary Tract ◽

The Body ◽

Urogenital System ◽

Cross Sectional ◽

Functional Changes ◽

Age Related ◽

Lower Urinary

In this review, the principal morphological and functional changes which occur in relationship to aging in both the genital tract and lower urinary tract are discussed. Aging of the upper urinary tract is not considered.Much of the evidence for age-related changes comes from cross-sectional studies with their inherent methodological limitations. Furthermore, it is difficult to accept ‘normal aging’ criteria that do not take into consideration the role of the acute and chronic disease so prevalent in elderly people. Thus, more longitudinal studies are needed in order to provide a more exact analysis of the influence of aging on the urogenital system, as for all other systems of the body.

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Laparoscopic Management of Ureteropelvic Junction Obstruction in Patients With Upper Urinary Tract Anomalies

The Journal of Urology ◽

10.1097/01.ju.0000098408.53959.cb ◽

2004 ◽

Vol 171 (1) ◽

pp. 77-79 ◽

Cited By ~ 47

Author(s):

PIERLUIGI BOVE ◽

ALBERT M. ONG ◽

KOON-HO RHA ◽

PETER PINTO ◽

THOMAS W. JARRETT ◽

...

Keyword(s):

Urinary Tract ◽

Ureteropelvic Junction Obstruction ◽

Upper Urinary Tract ◽

Ureteropelvic Junction ◽

Laparoscopic Management ◽

Urinary Tract Anomalies

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Variations in the Density and Distribution of Cajal Like Cells Associated With the Pathogenesis of Ureteropelvic Junction Obstruction: A Systematic Review and Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.721143 ◽

2021 ◽

Vol 8 ◽

Author(s):

U. M. J. E. Samaranayake ◽

Y. Mathangasinghe ◽

U. A. Liyanage ◽

M. V. C. de Silva ◽

M. C. Samarasinghe ◽

...

Keyword(s):

Systematic Review ◽

Urinary Tract ◽

Ureteropelvic Junction Obstruction ◽

Meta Analysis ◽

Upper Urinary Tract ◽

Pooled Analysis ◽

Ureteropelvic Junction ◽

Case Control Studies ◽

Cochrane Reviews ◽

Protocol Registration

Introduction: Cajal like cells (CLCs) in the upper urinary tract have an ability to generate coordinated spontaneous action potentials and are hypothesized to help propel urine from renal pelvis into the ureter. The objective of this review was to describe the variations in the density and distribution of CLCs associated with ureteropelvic junction obstruction (UPJO).Materials and Methods: Studies comparing the density and distribution of CLCs in the human upper urinary tract in patients with UPJO and healthy controls were included in this systematic review. We searched online electronic databases; Ovid MEDLINE, Scopus, PubMed and Cochrane reviews for the studies published before October 31, 2020. A meta-analysis was conducted to compare the density of CLCs at the ureteropelvic junction (UPJ) in patients with UPJO and matched controls.Results: We included 20 and seven studies in the qualitative and quantitative synthesis, respectively. In majority (55%) CLCs were located between the muscle layers of the upper urinary tract. The CLC density in the UPJ gradually increased with aging in both healthy subjects and patients with UPJO. The pooled analysis revealed that the density of CLCs at the UPJ was significantly low in patients with UPJO compared to the controls (SMD = −3.00, 95% CI = −3.89 to −2.11, p < 0.01).Conclusions: The reduction in CLC density at the UPJ in patients with UPJO suggests a contribution from CLCs in the pathogenesis of UPJO. Since age positively correlates with CLC density, it is imperative to carefully match age when conducting case control studies comparing the CLC density and distribution.Protocol Registration Number: CRD42020219882.

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