Recent trends of genitourinary endoscopy in children.
Downsizing and refinement of the pediatric endoscope in video-monitoring systems have facilitated genitourinary endoscopy even in small children without any traumatic instrumentation. Indications for endoscopy in children with hematuria or tractable urinary tract infection have been tailored for the rareness of genitourinary malignancy or secondary vesicoureteral reflux (VUR) as a result of infravesical obstruction. Most mechanical outlet obstructions can be relieved endoscopically irrespective of sex and age. Endoscopic decompression by puncture or incision of both intravesical and ectopic ureteroceles can be an initial treatment similar to open surgery for an affected upper moiety. Endoscopy is necessary following urodynamic study to exclude minor infravesical obstruction only in children with unexplained dysfunctional voiding. Genitourinary endoscopy is helpful for structural abnormalities before and at the time of repairing congenital urogenital anomalies. Endoscopic injection therapy of VUR has been established as a less invasive surgical treatment. Pediatric endoscopy will play a greater role in the armamentarium for most pediatric urological diseases through the analysis of visual data and discussion on the indications for endoscopy throughout the world.
Nonomura
Katsuya
K
Hokkaido University, Graduate School of Medicine and Department of Urology, Renal and Genitourinary Surgery, Sapporo, Japan. k-nonno@med.hokudai.ac.jp
Kakizaki
Hidehiro
H
D002648:Child; D012734:Disorders of Sex Development / Q000175:diagnosis / Q000628:therapy; D004724:Endoscopy / Q000379:methods / Q000639:trends*; D006801:Humans; D014518:Ureterocele / Q000175:diagnosis / Q000628:therapy; D014524:Urethral Obstruction / Q000175:diagnosis / Q000628:therapy; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000628:therapy