pediatric urinary disorders
DESCRIPTION
Pediatric urinary disorders . Dr. Hamdan Al- Hazmi. Objectives. Understand the common congenital anomalies The definition of each anomalies The most common radiological investigation used The common way of tratment. Congenital anomalies of the urogenital system. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/1.jpg)
DR. HAMDAN AL-HAZMI
Pediatric urinary
disorders
![Page 2: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/2.jpg)
Objectives
1. Understand the common congenital anomalies
2. The definition of each anomalies 3. The most common radiological investigation
used4. The common way of tratment
![Page 3: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/3.jpg)
Congenital anomalies of the urogenital system
Most common of all organ system.10% of population has some type of
urogenitalanomaly.14:1000 birth has antenatal diagnosis of
urogenitalanomaly.Antenatal ultrasound after 28 weeks
gestation.
![Page 4: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/4.jpg)
Congenital anomalies of the urogenital system…
Antenatal HydronephrosisAnomaly of position, number and rotationCystic abnormalitiesPrune Belly SyndromeHypospadiasEpispadiasBladder e Exstrophy
![Page 5: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/5.jpg)
Antenatal Hydronephrosis(ANH)
![Page 6: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/6.jpg)
Causes: Pelviureteric junction
obstruction (41%) Ureterovesical junction
obstruction (23%) Vesicoureteric reflux(7%) Duplication anomalies (13%) Posterior urethral valves (10
%) MCDK Others (6%)
Antenatal Hydronephrosis(ANH)
![Page 7: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/7.jpg)
SFU Grading8
G0 G2G1
G4G3
![Page 8: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/8.jpg)
1-Pelviureteric junction obstruction(PUJO)
![Page 9: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/9.jpg)
PUJO…
Presentation:Incidental in
NeonatesIncidental in ChildrenSymptomatic:
UTI Pain Mass Hematuria Stone
Pyeloplasty
![Page 10: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/10.jpg)
2-Ureterovesical junction obstruction (UVJO)
Ureteral reimplantation
![Page 11: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/11.jpg)
3-Duplication Anomalies
1%, 1.6:1 F:M85% unilateral.Complete or
incomplete Associated
reflux 43% renal dilatation 29% ectopic insertion 3% ureterocele.
![Page 12: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/12.jpg)
4-Ureterocele
![Page 13: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/13.jpg)
Ureterocele….
Cystic dilatation of the terminal portion of the ureter.
Orthotopic = intravesical=simple=adult type ureterocele.Ectopic = extravesical=duplex system= infant type ureterocele.In ectopic ureterocele it involve the upper pole system.7:1 F:M, 10% bilateral, ectopic: orthotopic 4:1Commonest cause of urine retention in female infants.
![Page 14: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/14.jpg)
5-Ectopic ureter
Most commonly associated with duplex system and with ureterocele.
Clinical picture depend on: associated anomalies, site and sex of the patient.
![Page 15: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/15.jpg)
6-Vesicoureteric Reflux
MCUG /VCUG
![Page 16: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/16.jpg)
6-Vesicoureteric Reflux….
All patient should started on prophylactic antibiotics
Surgical intervention :
Ureteral reimplantation
Endoscopic correction
![Page 17: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/17.jpg)
Normal anti-reflux mechanism “Flap valve” 1. Oblique course as it enters the bladder. 2. Proper muscular attachments to provide
fixation. 3. Posterior support to enable its occlusion. 4. Adequate submucosal length.
![Page 18: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/18.jpg)
7-Posterior urethral valves (PUV)…
![Page 19: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/19.jpg)
Posterior urethral valves (PUV)….
1:5000 male infants.most common cause of urine retention in
male infants.50% have renal impairment.The bladder and the kidneys developed under high pressure and resistance.
![Page 20: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/20.jpg)
8- Multicystic dysplastic kidney (MCDK)
![Page 21: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/21.jpg)
![Page 22: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/22.jpg)
Kidney Anomalies
Anomaly of position, number and rotation“1. Simple ectopia: - A kidney that is outside the renal fossa. - Pelvic (commonest), lumbar, sacral.2. Thoracic kidney.3. Horseshoe kidney4. Unilateral renal agenesis.5. Bilateral renal agenesis.6. Crossed renal ectopia with no fusion.7. Crossed renal ectopia withfusion.8. Malrotated kidney.
![Page 23: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/23.jpg)
Renal ectopia
![Page 24: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/24.jpg)
Horseshoe kidney
![Page 25: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/25.jpg)
Kidney…
Cystic abnormalities
1. Renal dysplasia A) congenital unilateral multicystic kidney. B) Segmental and focal renal dysplasia. C) Renal dysplasia associated with congenital lower tract obstruction.
2. Congenital polycystic kidney disease: A) Infantile type B) Adult type
3. Simple cyst4. Calyceal cyst5.Peripelvic cyst6. Perinephric cyst
![Page 26: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/26.jpg)
Prune Belly Syndrome
Triad syndrome fAbsent abdominal
wall muscle Bilateral undescended
testis Urinary tract dilatation
![Page 27: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/27.jpg)
Hypospadias
![Page 28: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/28.jpg)
Hypospadias
Abnormal position of the EUMDistal hypospadiasProximal hypospadiasNO Circumcision6 to 9 months repair
![Page 29: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/29.jpg)
![Page 30: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/30.jpg)
Hypospadias
Abnormal position of the EUMDistal hypospadiasProximal hypospadiasNO Circumcision6 to 9 months repair
![Page 31: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/31.jpg)
![Page 32: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/32.jpg)
Epispadias
![Page 33: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/33.jpg)
Bladder Exstrophy
![Page 34: Pediatric urinary disorders](https://reader035.vdocuments.us/reader035/viewer/2022062410/5681649c550346895dd68020/html5/thumbnails/34.jpg)
THANK YOU