Možnost řešení objemné ureterokély v dětském věku. Prezentujeme kazuistiku chlapce, který byl na našem pracovišti operován pro ureterokélu s mnohočetnou ureterolitiázou.

The possibility of solving a bulky uretererocele in childhood. We present a case report of a boy who was operated on at our institution for ureterocele with multiple ureterolithiasis.

• MeSH
• Diagnostic Techniques, Urological MeSH
• Child MeSH
• Endoscopy methods   MeSH
• Humans MeSH
• Nephrolithiasis therapy   MeSH
• Ureterocele * diagnostic imaging   diagnosis   complications   therapy   MeSH
• Urolithiasis diagnostic imaging   therapy   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Kidney Diseases, Cystic MeSH
• Child MeSH
• Kidney Pelvis abnormalities   MeSH
• Humans MeSH
• Kidney Diseases * MeSH
• Ureteral Diseases MeSH
• Ureteral Obstruction MeSH
• Ureter abnormalities   MeSH
• Ureterocele MeSH
• Vesico-Ureteral Reflux MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Review MeSH

Prenatální a postnatální ultrazvukový (UZ) screening zlepšil časný záchyt vad ledvin a močových cest. Dilatace kalichopánvičkového systému (KPS) ledviny - hydronefróza je nejčastěji zjišťovanou orgánovou abnormalitou. Nejen dětští nefrologové a urologové, ale každý praktický lékař pro děti a dorost (PLDD) má v péči děti s dilatací KPS. K určování závažnosti dilatace KPS jsou používány různé stupnice, v České republice byla pro postnatální dilataci KPS nejčastěji požívána klasifikace dle SFU. Tento článek seznamuje s novou mezinárodní "UTD klasifikací" dilatace močových cest, zahrnující prenatální i postnatální UZ nálezy. Uvádí výhody a nevýhody této klasifikace a konverzi z klasifikace SFU na UTD. V krátkých kazuistikách je demonstrováno správné načasování diagnostického postupu při různých stupních dilatace močových cest.

Prenatal and postnatal ultrasound (US) screening has improved the early detection of renal and urinary disorders. The most commonly identified organ abnormality is pelvicalyceal dilatation (PCD) - hydronephrosis. Apart from pediatric nephrologists and urologists, virtually all general pediatricians care for children with PCD. To determine the severity of PCD, various scales are used; in the Czech Republic, the SFU grading system has been most commonly used for postnatal PCD. The paper introduces the UTD classification of urinary tract dilatation, a novel international system including both prenatal and postnatal US findings. It explains the advantages and disadvantages of the classification as well as the conversion from the SFU to the UTD system. Short case reports demonstrate the proper timing of diagnosis with respect to different grades of urinary tract dilatation.

• Keywords
• pelviureterální junkce,
• MeSH
• Diagnostic Techniques, Urological MeSH
• Dilatation, Pathologic etiology   therapy   MeSH
• Hydronephrosis * diagnostic imaging   etiology   classification   MeSH
• Infant MeSH
• Kidney Pelvis * abnormalities   diagnostic imaging   pathology   MeSH
• Humans MeSH
• Urinary Tract abnormalities   diagnostic imaging   pathology   MeSH
• Ureteral Obstruction diagnosis   therapy   congenital   MeSH
• Ultrasonography methods   MeSH
• Ureterocele diagnosis   therapy   congenital   MeSH
• Vesico-Ureteral Reflux diagnosis   etiology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Hydronephrosis complications   MeSH
• Humans MeSH
• Infant, Newborn, Diseases MeSH
• Infant, Newborn MeSH
• Ultrasonography, Prenatal MeSH
• Ureterocele * diagnostic imaging   congenital   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

AIM: To assess of the role of renal ultrasonography (US) and DMSA renal scintigraphy in the prediction of irreversible histological lesions of the upper pole in duplex system. METHODS: A prospective cohort study based on data collected between 2005 and 2012 at our institution. The cohort consisted of 23 patients with ureteroceles and 28 patients with ectopic ureters who underwent upper pole nephrectomy. Preoperative recordings from ultrasound and nuclear renal scans were compared with the histological findings. Histological irreversible lesions were defined as the presence of dysplasia and/or severe chronic interstitial nephritis (CIN) in ≥ 90% of the specimen. ROC (Receiver Operating Characteristic) curves were used to investigate thresholds in order to identify irreversible lesions using various differential functions. The histology was correlated with the results of imaging. RESULTS: Pathological findings were found in all histological samples. Histological lesions were irreversible in 20/23 patients (87.0%) with ureteroceles and in 14/28 patients (50.0%) with ectopic ureters. The model is able to predict irreversible lesions if an upper pole differential function is ≤ 3% in patients with ureteroceles, and ≤ 2% in the presence of ectopic ureters. Weak association between parenchymal thinning on ultrasonography and irreversible lesions was found in patients with ectopic ureters. CONCLUSION: DMSA renal scintigraphy provides a useful tool for the prediction of irreversible lesions in the upper pole. Low differential function (≤ 3% and ≤ 2%, respectively) indicates irreversible lesions, favoring heminephrectomy. Higher differential function indicates greater remaining biological potential of the parenchyma, favoring reconstruction of the upper pole.

• MeSH
• Child MeSH
• Infant MeSH
• Succimer MeSH
• Kidney abnormalities   MeSH
• Humans MeSH
• Child, Preschool MeSH
• Prospective Studies MeSH
• Radionuclide Imaging MeSH
• ROC Curve MeSH
• Ultrasonography MeSH
• Ureter abnormalities   MeSH
• Ureterocele diagnostic imaging   MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH
• Comparative Study MeSH

Vrozené vývojové vady horních močových cest tvoří významnou skupinu onemocnění, kde je část dětí nutné operovat. Laparoskopie stejně jako v jiných oblastech chirurgie i zde nabídla výhody miniinvazívní chirurgie. Poskytuje možnost zvětšení obrazu, přesnou disekci tkání a tím minimalizaci operačního traumatu. Menší operační trauma je spojeno se sníženou spotřebou analgetik, kratší hospitalizací a to při zachování dobrých funkčních výsledků a bezpečnosti dítěte. V neposlední řadě je spojena s výborným kosmetickým výsledkem, jehož význam roste s věkem pacienta. Výkony jsou prováděny jak pro obstrukční, tak refluxní vady ledvin se simplexními i zdvojenými kalichopánvičkovými systémy. Na některých pracovištích jsou laparoskopické operace u vybraných skupin těchto onemocnění upřednostňovány před otevřenou operací. Sporný zatím zůstává benefit laparoskopie u nejmenších dětí, zejména mladších jednoho roku. Retroperitoneoskopie podobně jako otevřené výkony nabízí možnost operovat primárně retroperitoneálně uložené orgány jako ledviny a vývodné močové cesty bez nutnosti vstupu do břišní dutiny. Představuje také alternativu u dětí, kde transperitoneální laparoskopický výkon není z různých důvodů možný nebo je spojen s vyšším operačním rizikem.

Congenital defects of upper urinary tract, represents an important group of surgically treated problems in paediatric urology. Laparoscopy brings an advantage of miniinvasive approach to this field of surgery. It offers possibility of view magnification with precise tissue dissection and minimal surgical trauma. Decreased operation trauma is associated with decreased analgesic consumption, shorter hospital stay with preserved good functional results and child safety. It is also associated with excellent cosmetic results mainly important for older patients. Procedures are performed for both, obstructive and refluxing uropathies in simplex and also in duplex kidney anomalies. In some institutions are laparoscopic procedures in selected cases methods of choice before open ones. Still controversial is benefit of laparoscopy for youngest children, especially under one year of age. Retroperitoneoscopy offers possibility of extraperitoneal approach to the primary retroperitoneal organs like a kidney, renal pelvis and ureter. It also represents an alternative for children where transperitoneal laparoscopic approach is not possible or is potentially associated with increased surgical risks.

• MeSH
• Child MeSH
• Urinary Diversion methods   MeSH
• Hydronephrosis surgery   congenital   MeSH
• Laparoscopy methods   MeSH
• Humans MeSH
• Urinary Tract * abnormalities   surgery   MeSH
• Nephrectomy methods   MeSH
• Pyonephrosis surgery   congenital   MeSH
• Ureterocele surgery   congenital   MeSH
• Urologic Surgical Procedures methods   MeSH
• Vesico-Ureteral Reflux surgery   congenital   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Child MeSH
• Kidney * abnormalities   MeSH
• Humans MeSH
• Urinary Tract abnormalities   MeSH
• Ureteral Obstruction * diagnosis   pathology   therapy   MeSH
• Ureter pathology   MeSH
• Ureterocele diagnosis   therapy   MeSH
• Congenital Abnormalities * MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Kidney Diseases, Cystic diagnosis   physiopathology   congenital   MeSH
• Diagnostic Techniques, Urological utilization   MeSH
• Child MeSH
• Hydronephrosis etiology   classification   therapy   MeSH
• Kidney abnormalities   MeSH
• Humans MeSH
• Urinary Tract abnormalities   MeSH
• Kidney Diseases diagnosis   MeSH
• Ureteral Diseases diagnosis   complications   congenital   MeSH
• Fetal Diseases diagnosis   MeSH
• Infant, Newborn MeSH
• Urethral Obstruction diagnosis   physiopathology   therapy   MeSH
• Fetus MeSH
• Prenatal Diagnosis MeSH
• Ureter abnormalities   physiopathology   MeSH
• Ureterocele congenital   MeSH
• Urologic Diseases diagnosis   MeSH
• Vesico-Ureteral Reflux diagnosis   surgery   MeSH
• Congenital Abnormalities diagnosis   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Female MeSH

Autoři popisují čtrnáctidenního novorozence, u kterého byla zjištěna při postnatálním ultrazvukovém screeningu oboustranná hydronefróza s oboustrannými megauretery. Mikční cystografie vyloučila vezikoureterální reflux a prokázala defekty v kontrastní náplni močového měchýře, oboustranné ureterokély. Ve věku jednoho měsíce byla v celkové anestezii provedena diagnosticko-léčebná cystoskopie s discizí obou ureterokél.

• MeSH
• Anesthesia, General MeSH
• Cystoscopy MeSH
• Humans MeSH
• Urinary Bladder surgery   MeSH
• Kidney Diseases etiology   MeSH
• Infant, Newborn MeSH
• Ultrasonography MeSH
• Ureter surgery   pathology   MeSH
• Ureterocele surgery   MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Biochemistry methods   MeSH
• Diagnostic Techniques, Urological utilization   MeSH
• Child MeSH
• Kidney Pelvis physiopathology   pathology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   utilization   MeSH
• Urethral Diseases diagnosis   therapy   MeSH
• Prenatal Diagnosis methods   utilization   MeSH
• Radionuclide Imaging methods   utilization   MeSH
• Severity of Illness Index MeSH
• Tomography, Spiral Computed methods   utilization   MeSH
• Ultrasonography methods   utilization   MeSH
• Ureterocele diagnosis   therapy   MeSH
• Urography methods   utilization   MeSH
• Urologic Surgical Procedures methods   utilization   MeSH
• Urologic Diseases diagnosis   classification   therapy   MeSH
• Check Tag
• Child MeSH
• Humans MeSH