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CNAA / Theses / 2007 / May /

Hidrocaliconephrosis at children, methods of diagnostics and treatment


Author: Ahmad Al Share
Degree:doctor of medicine
Speciality: 14.00.40 - Urology
Year:2007
Scientific adviser: Boris Curajos
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 2 May, 2007
Approved by NCAA on the 14 June, 2007

Abstract

Adobe PDF document0.65 Mb / in romanian

Thesis

CZU 616.613-007.63-07-08-053.2

Adobe PDF document 2.10 Mb / in russian
112 pages


Summary

Dilation of renal cavities at children, according to our data makes up 30 % of all urological patients, the reason of this disease can be the disturbance of the urodynamics at the level of pyelouretheral segment. For the determination of the reasons and level of the obstruction, the algorithm of the methods of the patients with pyeloectasia disease examination and sequence of their realization was elaborated.

As a result of 1241 children with pyeloectasia examination, the obstruction PUS is revealed at 189 children, 143 have obstructive megauretheralhydronephrosis, 464 have cystic- urethral reflux, 174 – neurogenic urinary bladder, 20 – doubling of the kidneys, 86 – inborn stenosis and 14 – valve of the back urethra. The patients have been fully examined, including general clinic, ultra sonography and scintigraphy using diuretics, excretory urography and voiding cystic –urethrography, paracentetic biopsy of the kidneys. When carrying out diuretic ultrasonography at 81 children with PUS obstruction, non-obstructive variant was revealed at 23, partially – obstructive at 4 and obstructive at 54 persons. Functional obstruction PUS was determined at 23 children, organic at 156 - in 68% narrowing PUS, at 12, 2% - aberant vessels, high origin at 9, 6% and others. 156 patients had been operated for 159 times (3 persons had double-sided) in general according to the method of Anderson-Hynes (53, 4%) with obligatory catchment of the kidneys cavities.

Rate of D/P decreased at the majority of children after surgery, 18 of them had low D/P before surgery, and there was no amelioration. The index of the D/P rate may be useful index for observation in dynamics for hydronephrosis evolution and may be used when evaluating the results of the treatment.