TY - JOUR
T1 - Urinary tract reconstruction in children undergoing renal transplantation
AU - Ewalt, D. H.
AU - Allen, T. D.
PY - 1996
Y1 - 1996
N2 - In children, congenital urinary tract anomalies contribute to end-stage renal disease in 20% to 30% of cases. As more and more children with myelomeningocele, posterior urethral valves, prune belly syndrome, and other serious congenital anomalies of the urinary tract survive early infancy, more of these patients will be in need of renal transplantation. Of these, a significant proportion will have persisting abnormal anatomic and physiological characteristics of the urinary tract requiring reconstructive surgery before transplantation. Before undertaking these procedures, urologic evaluation should be performed in all such children. Comprehensive evaluation includes a careful history and physical examination with radiological imaging of the urinary tract (renal ultrasonography and voiding cystourethrography). In selected instances, further evaluation of bladder function and urethral anatomy may require urodynamic evaluation or cystourethroscopy. The goal of these investigations is to ensure that the bladder will hold urine at a low intravesical pressure during the storage phase and that it can be evacuated with certainty. This presentation focuses on the pretransplantation evaluation and the various possible urinary tract reconstructions that may be performed in children destined for renal transplantation.
AB - In children, congenital urinary tract anomalies contribute to end-stage renal disease in 20% to 30% of cases. As more and more children with myelomeningocele, posterior urethral valves, prune belly syndrome, and other serious congenital anomalies of the urinary tract survive early infancy, more of these patients will be in need of renal transplantation. Of these, a significant proportion will have persisting abnormal anatomic and physiological characteristics of the urinary tract requiring reconstructive surgery before transplantation. Before undertaking these procedures, urologic evaluation should be performed in all such children. Comprehensive evaluation includes a careful history and physical examination with radiological imaging of the urinary tract (renal ultrasonography and voiding cystourethrography). In selected instances, further evaluation of bladder function and urethral anatomy may require urodynamic evaluation or cystourethroscopy. The goal of these investigations is to ensure that the bladder will hold urine at a low intravesical pressure during the storage phase and that it can be evacuated with certainty. This presentation focuses on the pretransplantation evaluation and the various possible urinary tract reconstructions that may be performed in children destined for renal transplantation.
KW - Noncompliant bladder
KW - obstructive uropathy
KW - reconstruction
KW - renal transplantation
KW - urethral valves
UR - http://www.scopus.com/inward/record.url?scp=0030061954&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030061954&partnerID=8YFLogxK
U2 - 10.1016/S1073-4449(96)80042-2
DO - 10.1016/S1073-4449(96)80042-2
M3 - Article
C2 - 8620370
AN - SCOPUS:0030061954
SN - 1073-4449
VL - 3
SP - 69
EP - 76
JO - Advances in Renal Replacement Therapy
JF - Advances in Renal Replacement Therapy
IS - 1
ER -