Przydatność badań ultrasonograficznych w rozpoznawaniu i w ocenie odległych wyników leczenia operacyjnego zwężenia podmiedniczkowego moczowodu u noworodków

Bibliogr. s. 61

Background: Pyeloureteral stricture in neonates requires early diagnosis and treatment for the reason that leads to infections, formation of concrements and destruction of renal parenchyma. Aim: Evaluation of usefulness of ultrasound examinations in diagnosis of neonatal pyeloureteral stricture and their value in postoperative follow-up. Material/Methods: The study comprised of 54 newborns (33 boys and 29 girls) with pyloureteral stricture diagnosed by ultrasound, including 52 (96%) of unilateral (27 left and 25 right sided) and 2 cases of bilateral stricture. In 15 (28%) neonates high-grade pelvic dilatation was found. Results: Operative treatment with use of Anderson-Hynes method was applied in 6(11%) of children in first month of life, in 21 (39%) of children between 2 and 6 month of life and in 27(50%) in second half of first year of life. Long-term follow-up was performed in 46 children of mean age 7,8 years using abdominal ultrasound. The very good result of surgical intervention was noted in 50% of children, good effect in 43,5% and poor outcome in 3 children: 1 with large pelvic dilatation and two cases with lack of renal function confirmed by scintigraphy. Conclusions: Abdominal ultrasound in neonates allow not only to make early diagnosis of pyeloureteral stricture but also provide quick and proper qualification to operative treatment. Abdominal ultrasound, among other ways of imaging, as a safe and useful, should be method of choice in follow-up after operative treatment of pyeloureteral stricture in children. Follow-up using abdominal ultrasound in children after Anderson-Hynes operation confirm beneficial effects of such treatment on reconstruction of dynamics of upper urinary tract, prevention of deformation of pyelocaliceal system and damage of renal parenchyma.