| Objective: To investigate furtherly clinical standard diagnosis and treatment of renal duplication in children.Methods: The clinical data of 56 cases of childrens,renal duplication were retrospectively analyzed in our hospital in the past 12 years(male 17 and female 39,left 17,right 31 and bilateral 8,age ranged from 2 days to 13 years).A total of 11 cases of renal duplication were diagnosised by antenatal examination and 9 cases diagnosised by postnatal examination.To see doctors' office visiting with 18 cases of urinary incontinence(1 case with urinary tract infection and 1 case with abdominal pain),7 cases with low back pain,5 cases with abdominal pain,3 cases with urinary tract infection,2 cases with body surface mass,and 1 case with urethral mass.All kinds of renal duplication were diagnosised by B-Ultrasound,Intravenous Urography(IVU),Magnetic Resonance Urography(MRU),Single-Photon Emission Computed Tomography Radionuclide Renal Dynamic Imaging(SPECT),Voiding Cystourethrography(VCUG)and Retrograde Pyelography(RP).And the results were as follows: renal duplication with complete double ureter in 49 cases,renal duplication with "Y" ureter in 7 cases,upper renal duplication in 51 cases and lower renal duplication in 5 cases.11 underwent conservative treatment and followed by observation in 56 cases and 45 underwent surgery.Results: Among of them,11 cases of renal duplication without hydronephrosis and normal IVU imaging were observed following-up.35 cases with non-function renal duplication by no IVU imaging and SPECT detecting GFR(glomerular filtration rate)had resected renal duplication and their ureter.The 3 cases of renal duplication with ureteral duplication dilatation(Diameter larger than 4.0cm)had done anastomosis between duplex kidney and lower renal pelvis.And another 5 cases of renal duplication with ureteral duplication dilatation(less than 4.0cm in diameter)with end-stage cyst of ureter(without vesicoureteral reflux)had done ureteral cyst puncture and 2 cases without end-stage cyst of ureter had done the replantation between ureteral duplication and bladder.All patients were followed up from 6 months to 7 years with average following-up 5 years.The clinical symptoms of result cases have disappeared after operation except for 1 patient with urinary incontinence due to the operration of sacro-meningocele with neurogenic bladder.Conclusion: Renal duplication in children have diverse clinical manifestations.It is helpful to diagnose renal duplication by B-ultrasound,IVU,SPECT and urinary MRU,VCUG and Retrograde pyelography.Individual Treatment of renal duplication should be executived on based function of renal duplication and ureteral ectopic opening. |
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