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Journal of the Korean Society of Pediatric Nephrology 1999;3(1): 88-94.
소아 선천성 요로계 기형에 관한 고찰
신원혜, 고철우, 구자훈, 정성광
1경북대학교 의과대학 소아과학교실
2경북대학교 의과대학 비뇨기과학교실
3경북대학교 의과대학 비뇨기과학교실
4경북대학교 의과대학 비뇨기과학교실
Congenital Anomaly of Urinary Tract in Children
Weon Hye Shin, Cheol Woo Ko, Ja Hoon Koo, Sung Kwang Chung
1Department of Pediatrics, Kyungpook National University, College of Medicine
2Department of Urology, Kyungpook National University, College of Medicine
3Department of Urology, Kyungpook National University, College of Medicine
4Department of Urology, Kyungpook National University, College of Medicine
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ABSTRACT
Purpose : Malformation of urinary tract is among the most common of all congenital anomalies and can progress to irreversible renal damage before diagnosis due to difficulty of early diagnosis. Present study was undertaken to determine the clinical characteristics of urinary tract anomaly and to find out the most appropriate diagnostic and therapeutic measures for children with these anomalies.
Methods : During the past 10 years from 1987 to 1998, review of medical records revealed 65 children with congenital anomaly of urinary tract and the following results were obtained.
Results : The most common anomalies were ureteropelvic junction obstruction occuring in 26 cases ($36%$), followed by ureteral duplication in 11 cases, renal agenesis in 10 cases and ureterovesical function obstruction in 7 cases. Complex anomaly of urinary tract was found in 8 cases and anomaly of other systems such as congenital heart disease was detected in 11 cases. The most frequent age group at the time of diagnosis was below 1 year of age constituting 39 cases ($60%$) and male preponderance was noted as male to female ratio being 2.25:1. Presenting symptoms were urinary tract infection in 25 cases, followed by hematuria, abdominal mass, abdominal pain and voiding difficulty, etc, and in 11 cases, the anomaly was picked up by routine prenatal ultrasonography. Azotemia was noted in 9 cases and the underlying anomaly was obstructive uropathy in 4 out of these 9 cases. Surgical correction was undertaken in 38 cases (most frequently in cases of obstructive uropathy) and in 2 out off cases with obstructive uropathy in whom surgical correction was done, azotemia disappeared during follow up period of 1-5years. No new cases of deteriorating renal function appeared during follow-up period.
Conclusion : In spite of high incidence of congenital malformation of urinary tract, early diagnosis is still hampered by nonspecific symptoms and signs. Therefore, in patients with symptoms such as urinary tract infection, abdominal pain and voiding problems, etc, it Is advisable to take various diagnostic tests promptly to pick up any urinary tract anomaly and to apply proper therapy in order to avoid progression to irreversible renal damage. In this regard, prenatal ultrasonography should be utilized more widely as a routine procedure to detect any urinary tract anomalies before birth.
Key words: Urinary malformation
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