Abstract
Congenital urinary tract obstruction is distinct from obstruction in the mature kidney in as much as it induces various degrees of renal dysplasia and hypoplasia. The vast majority of prenatally detected uropathies does not require fetal interventions because of acceptable postnatal renal function and unacceptably high fetal morbidity and mortality secondary to the procedure. Symptoms vary depending on age of diagnosis and include urinary tract infection, urosepsis, failure to thrive, pain, nausea, hematuria, and hypertension. The underlying principle for the determination of obstruction by imaging studies is delayed excretion of contrast agents/tracers in a dilated urinary system. The availability of only two treatment options for urinary tract obstruction, observation or surgery, has created a great deal of controversy when to intervene. Indications for surgery are greatly individualized and depend on a multitude of clinical variables including the urologist’s experience and parental preference. This chapter discusses the etiology, epidemiology, presentation, diagnosis, and treatment of the most common and some rare entities of urinary tract obstruction in children.
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Abbreviations
- US:
-
Ultrasound
- IVP:
-
Intravenous pyelography
- VUR:
-
Vesicoureteral reflux
- UTI:
-
Urinary tract infection
- ESRD:
-
End stage renal disease
- UPJ:
-
Ureteropelvic junction
- VCUG:
-
Voiding cystourethrography
- MAG-3:
-
Mercaptoacetyltriglycine
- DTPA:
-
Diethylenetriaminepentaacetic acid
- DRF:
-
Differential renal function
- T1/2:
-
Half time excretion of radiotracer
- MRU:
-
Magnetic resonance urography
- RTT:
-
Renal transit time
- RPG:
-
Retrograde pyelogram
- IVC:
-
Inferior vena cava
- CT:
-
Computed tomography
- MRI:
-
Magnetic resonance imaging
- UVJ:
-
Ureterovesical junction
- PUV:
-
Posterior urethral valves
- AUV:
-
Anterior urethral valves
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Cerwinka, W.H., Kirsch, A.J. (2011). Urinary Tract Obstruction. In: Palmer, J. (eds) Pediatric Urology. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-420-3_15
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DOI: https://doi.org/10.1007/978-1-60327-420-3_15
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