Diagnosis and treatment of coexisting ureteropelvic junction obstruction and ureterovesical junction obstruction
10.3760/cma.j.issn.2095-428X.2017.23.011
- VernacularTitle:肾盂输尿管连接部梗阻合并输尿管膀胱连接部梗阻的诊断与治疗
- Author:
Xiaojiang ZHU
1
;
Juan DONG
;
Geng MA
;
Yunfei GUO
Author Information
1. 210008,南京医科大学附属儿童医院泌尿外科
- Keywords:
Child;
Hydronephrosis;
Ureteropelvic junction obstruction;
Ureterovesical junction obstruction;
Urography
- From:
Chinese Journal of Applied Clinical Pediatrics
2017;32(23):1797-1799
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnosis,treatment options and outcomes of patients with ureteropelvic junction obstruction(UPJO)and ureterovesical junction obstruction(UVJO). Methods Clinical records of 12 children with UPJO and UVJO who received treatment in Children′s Hospital of Nanjing Medical University from April 2008 to December 2015 were reviewed. Presentations included prenatal hydronephrosis and symptoms caused by urinary tract in-fections. Ultrasonography,intravenous pyelography,magnetic resonance imaging and renography were performed before surgery. Results Four patients underwent nephrostomy,followed by pyeloplasty and eventually,ureteroneocystostomy. Five patients underwent heterochronic pyeloplasty plus ureteroneocystostomy. Two patients received pyeloplasty only. And another patient underwent heterochronic nephrostomy plus ureteroneocystostomy. The 12 patients received a 2. 0 months to 2. 5 years′ follow - up. Recurrent urinary tract infection and abdominal pain were relieved after the treatment. Ultrasonography showed hydronephrosis reduced obviously after the surgery. Conclusions UVJO patients with unparallel hydronephrosis should be considered with the coexistence of UPJO. Retrograde pyelography(RPG)is recommended for the diagnosis. And the treatment includes both pyeloplasty and ureteroneocystostomy. The patients diagnosed with UPJO should be first managed with pyeloplasty or nephrostomy instead of RPG. Subsequently anterograde pyelography can be performed to decide if the patients need additional ureteroneocystostomy.
