[Development of the diagnosis and treatment of pyelo-ureteral duplication in children. Reflections on 179 cases].
The method of diagnosis and therapeutic rules for pathological ureteral duplicity has been highly developed over the last few years. Recent advances in fetal ultrasonography sometimes allow an early diagnosis of renal or intravesical cystic structure to be appraised before complications (urinary tract infection or pyelonephritis, prolapsed ureterocele, recurrent orchitis, primary diurnal and nocturnal urinary incontinence with conserved micturation for a young girl). However, the basis of therapeutic rules remain unchanged, the superior pyelocaliceal system is not preserved in most cases of ureterocele with ureteral duplicity or ectopic ureter, because of major cystic dysplasia; although, in some cases when an earlier diagnosis is made, conservative treatment (primary endoscopy followed by a surgical intervention if necessary) can be proposed. Likewise, the endoscopic injection of Teflon causes the vesico-ureteral reflux to disappear in most cases (70%).
Dodat
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H
Service de chirurgie pédiatrique, Hôpital Edouard-Herriot, Lyon, France.
Beck
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F
el Khoury
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G
Takvorian
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P
D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000175:diagnosis; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007682:Kidney Pelvis / Q000002:abnormalities*; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D014463:Ultrasonography; D014513:Ureter / Q000002:abnormalities*; D014518:Ureterocele / Q000150:complications / Q000628:therapy; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000628:therapy
Evolution du diagnostic et du traitement des duplicités pyélo-urétérales chez l'enfant. Réflexions à partir de 179 cas.