[Care and treatment of uropathies detected in utero. Evaluation of an 8-year experiment].
Over an 8 year period, the antenatal diagnosis of uropathy has been evoked for 125 fetuses, but confirmed only in 22%; in the other cases, it was insufficient (50%) or wrong (28%). Early surgery was useful only in few cases during the first days of life (section of urethral valves, temporary nephrostomy); in most cases, surgery was performed between 1 and 3 months of age; total or partial nephrectomy (mainly for multicystic dysplasia and ureteral duplication with ureterocele or ectopy), and generally conservative surgery (resection of pyelo-ureteral junction, vesico-ureteral reimplantation because of reflux or mega-ureter). The long-term results depend upon the degree of renal dysplasia: the prognosis is good in all the cases of operated hydronephrosis, but is often poor in uropathies characterized by early obstructive phenomena during intra-uterine life such as urethral valves. In those cases, the course of renal insufficiency cannot always be prevented by neonatal surgery.
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Service de chirurgie pédiatrique, Hôpital Edouard-Herriot, Lyon, France.
D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D006869:Hydronephrosis / Q000628:therapy; D007690:Polycystic Kidney Diseases / Q000628:therapy; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D014521:Urethra / Q000002:abnormalities; D014570:Urologic Diseases / Q000175:diagnosis / Q000628:therapy*
Prise en charge et traitement des uropathies dépistées in utero. Bilan d'une expérience de 8 ans.