Role of prenatal diagnosis in the treatment of congenital obstructive megaureter in a solitary kidney.
Congenital megaureter in a solitary kidney (CMSK) is a life-threatening disease. From January 1988 to December 1993, we treated 9 patients for CMSK (2 cases with unilateral renal dysplasia and 7 with unilateral renal agenesis). In 7 cases, the malformation was detected by prenatal ultrasonography and urological counseling. The ages at first postnatal observation ranged from 24 h to 5 years (mean = 8 months). The postnatal urological workup included: serum renal function screening, urinary system ultrasonography, a micturition cystogram, intravenous pyelography and a nuclear renal scan. The therapy of choice was decided on the basis of renal function. One emergency divertive procedure was performed after birth, in 3 cases of renal failure in the first 2 weeks of life. The remaining cases were operated electively at an average age of 20 months. In 2 cases that underwent delayed surgical elective correction and in 1 of the 3 cases that underwent an emergency diversion, some degree of renal failure still persists. In our opinion, prenatal diagnosis, accurate postnatal urological workup and strict postoperative follow-up are fundamental to avoid the devastating consequences of CMSK on the affected child.
Caione
P
P
Department of Pediatric Urology, Bambino Gesú Children Hospital, Rome, Italy.
Patricolo
M
M
Lais
A
A
Capitanucci
M L
ML
Capozza
N
N
Ferro
F
F
D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000503:physiopathology; D011247:Pregnancy; D051437:Renal Insufficiency / Q000209:etiology; D016216:Ultrasonography, Prenatal; D014513:Ureter / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*