Clinical Diagnosis And Treatment Of Special Types Of Congenital Hydronephrosis In Children (Report Of 11 Cases)

Objective:This thesis is aimed to discuss the clinical treatment, imaging examination, laparoscopic surgery of congenital hydronephrosis and the ways of dealing with complex and rare cases.Methods:11 cases which were diagnosed with complex hydronephrosis from January 2014 to December 2015 in Qilu Hospital of Shandong University are analyzed retrospectively. Combining with domestic and international literature, discuss the clinical manifestations, diagnosis and treatment of congenital hydronephrosis.Results:We collected 11 cases of complex hydronephrosis diagnosed and treated in Qilu Hospital of Shandong University from January 2014 to December 2015. Including 9 males an 2 females (4.5:1);the age of patients range from 4 months to 18 years old,7.7 years old in average.1 case of upper ureter obstruction;3 cases of lower ureteral calculi;3 cases of duplication kidney and hydronephrosis of the lower kidney;2 cases of ureteral polyps and 2 cases of huge hydronephrosis.Conclusions:Congenital nephrosis is a common disease in the department of pediatric surgery. UPJO, UVJO and ureter cyst are common causes of the disease. On the early phase of congenital nephrosis there could be no clinical symptoms, when the process comes to an advanced stage, symptoms like abdominal and waist mass, pain, urinary infection could be seen. The diagnosis of congenital nephrosis should depend on both clinical symptoms and imaging examinations including B-ultrasound, MRU, IVU, ECT, retrograde urography and so on.As the disease has a chance to recover without treatment, conservative therapy is suggested in many cases, but if hydronephrosis becomes increasingly worse, surgical treatment must be taken. Anderson-Hynes pyeloplasty is the best choice in most cases, as it has obvious curative effect with least complications.But when it comes to some rare and complex cases like big ureteral calculi, duplication kidney and hydronephrosis of the lower kidney, ureteral polyps, A-H pyeloplasty fits not, individual-based treatment should be taken. Nephrectomy should not be easily done as the kidney has a chance to recover in children cases.