Hydronephrose und Blasenentleerungsstörung
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- 作者：Dr. M. Schäfer ; M. Stehr
- 关键词：SchlüsselwörterPerinatale Urologie ; Pränataler Ultraschall ; Harnröhrenklappen ; Ureterabgangsstenose ; Primärer obstruktiver Megaureter
- 刊名：Monatsschrift Kinderheilkunde
- 出版年：2016
- 出版时间：October 2016
- 年：2016
- 卷：164
- 期：10
- 页码：875-882
- 全文大小：713 KB
- 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Pediatrics
General Practice and Family Medicine - 出版者：Springer Berlin / Heidelberg
- ISSN：1433-0474
- 卷排序：164
文摘
Due to increasing use of ultrasound in prenatal care, the vast majority of urological malformations can be detected prenatally; however, it is often not possible to ascertain a specific pathology with sufficient certainty. Additionally, there is a considerable risk of diagnosing clinically insignificant findings; therefore, prenatal counselling of the parents is paramount, which needs to include all specialists involved (e. g. obstetrics, neonatology, pediatric nephrology, pediatric surgery and urology). Postnatally, ultrasound is still the workhorse in primary diagnostics, while further information is obtained by a voiding cystourethrogram (VCUG), mercaptoacetyltriglycine (MAG3) and dimercaptosuccinic acid (DMSA) renal scintigraphy and magnetic resonance (MR) urography. In cases of primary obstructive megaureter and vesicoureteral reflux, there is a high rate of spontaneous resolution, which limits the needs for definitive surgical repair in the first year of life. Nevertheless, these children need continuous and close urological monitoring, both clinically and with ultrasound. In children with ureteropelvic junction obstruction early and, if necessary, repeated MAG3 renal scintigraphy leads to detection of those cases which need early surgical repair. In boys with posterior urethral valves, interdisciplinary collaboration has to be emphasized. After initial neonatological stabilization these children need early relief of the obstruction and then resection of the ureteral urethral valves, followed by continuous surveillance of both pediatric urology and nephrology.