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Urinary tract infection is one of the most common bacterial infections in pediatrics. The objective of our work is to determine the epidemiology and the profile of patients likely to develop a urinary infection in pediatric surger...
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Urinary tract infection is one of the most common bacterial infections in pediatrics. The objective of our work is to determine the epidemiology and the profile of patients likely to develop a urinary infection in pediatric surgery. Patients and method: This is a prospective, descriptive study conducted in the pediatric surgery department of the Albert Royer Children’s Hospital in Dakar over a period of 14 months, from April 1, 2020 to May 31, 2021. Results: We collected 36 patients, representing 3.08% of the patients hospitalized and followed during the study period. The average age was 3 years and infants represented 41.6%. The sex ratio was 3. Thirty-three patients had abnormalities of the urinary tract defect, including 21 posterior urethral valves (58.7%). Fourteen patients (38.9%) had a history of urinary catheterization. Probabilistic antibiotic therapy combining a 3rd generation cephalosporin and an aminoglycoside was used as first-line treatment in 22 cases (61%). Adaptation of antibiotic therapy was necessary in 4 patients with multi-resistant bacteria secreting extended-spectrum β-lactamase. Ten patients presented a recurrence requiring circumcision in 5 children with urinary tract abnormalities. Conclusion: Urinary tract infections are frequent in pediatric surgery. They mainly affect male infants with urinary tract abnormalities or who have had an urinary catheterization.
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Aim of the study: Extended spectrum beta lactamase (ESBL) producing bacteria are resistant to most beta-lactam antibiotics including third-generation cephalosporins, quinolones and aminoglycosides. This resistance is plasmid-borne...
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Aim of the study: Extended spectrum beta lactamase (ESBL) producing bacteria are resistant to most beta-lactam antibiotics including third-generation cephalosporins, quinolones and aminoglycosides. This resistance is plasmid-borne and can spread between species. Management of ESBL is challenging in children with recurrent urinary tract infections (UTIs) and complex urological abnormalities. We aim to quantify the risk in children and specifically in urological patients.
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Congenital posterior urethroperineal fistula (CUPF) is a urothelium-lined tract between the posterior urethra and perineum. This condition is rare and has been proposed to be a urethral duplication variant. A case of CUPF that was...
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Congenital posterior urethroperineal fistula (CUPF) is a urothelium-lined tract between the posterior urethra and perineum. This condition is rare and has been proposed to be a urethral duplication variant. A case of CUPF that was misdiagnosed and surgically treated as a rectourethral fistula is presented. The clinical presentation, diagnosis, and treatment of CUPF are discussed and compared with those of Y-type urethral duplications and H-type rectourethral fistulas. UROLOGY 158: 193-196, 2021. (c) 2021 Elsevier Inc.
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The purpose of this study was to compare the outcome of infants having antenatally detected urinary tract abnormalities (AUTAs) with respect to the presence of hydronephrosis in postnatal ultrasonography (US) examination.
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The aim of this study was to estimate the prevalence of vesicoureteral reflux (VUR) and clinically significant ultrasonography (US) abnormalities in a large group of children with proven and suspected urinary tract infection (UTI)...
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The aim of this study was to estimate the prevalence of vesicoureteral reflux (VUR) and clinically significant ultrasonography (US) abnormalities in a large group of children with proven and suspected urinary tract infection (UTI). The medical reports on renal US and voiding cystouretrographies (VCUG) of 2,036 children were reviewed. Renal US was performed on all children and VCUG on 1,185 children (58%). Based on the urine culture data, the UTI diagnoses were classified into five reliability classes (proven, likely, unlikely, false and no microbial data). The UTI diagnose was considered proven in 583/2036 (28.6%) and false in 145 (7.1%) cases. The prevalence of VUR was similar among those with proven and false UTI [37.4 vs. 34.8%; relative risk (RR) 1.08, 95% confidence intervals (95% CI) 0.7–1.7, P = 0.75] and decreased with increasing age (P = 0.001). Clinically significant US abnormalities occurred in 87/583 (14.9%) cases with proven UTI and significantly less often (11/145, 7.6%) in the false UTI class (RR 1.96, 95% CI 1.1–3.6, P = 0.02). Our finding supports the claim that VUR is not significantly associated to UTI and that its occurrence among children even without UTI is significantly higher than traditional estimates. This challenges the recommendations of routine VCUG after UTI.
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Objective: This article in to study the association of structural abnormalities of the urinary tract in children with urinary tract infection (UTI) using ultrasound examination.Methods : 262 children with culture proven urinary tr...
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Objective: This article in to study the association of structural abnormalities of the urinary tract in children with urinary tract infection (UTI) using ultrasound examination.Methods : 262 children with culture proven urinary tract infection were studied. Antibiotics were given as per sensitivity pattern. All children had an ultrasound of the abdomen done within 3 weeks. A micturating cystourethrogram (MCU) was done in those with abnormalities of the lower urinary tract detected on ultrasound, as well as in those who had recurrence of infection, after a normal ultrasound. IVU and renal isotope scans were done in selected cases.Result : All children were followed up until one year after the study period. Fifty-four patients had an underlying urinary tract anomaly; 42 were picked up by ultrasound and 12 by MCU. 22.9% of males and 15.9% of females had anomaly of the urinary tract. Children less than 2 years had the highest incidence of anomalies.Conclusion : Pelviureteric junction obstruction with hydronephrosis, vesicoureteric reflux and non-refluxing megaureter are the major anomalies picked up. 20% of children with urinary tract infections have an underlying structural abnormality of the urinary tract, three-fourth of which are picked up on ultrasound. An ultrasound abdomen is recommended in all children after the first UTI. In addition, an MCU is also indicated in all boys below 2 years with UTI, since one-third of anomalies will be missed if only ultrasound is done.
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Objective: To determine the proportion of ultrasound abnormalities of the urinary system between two groups of children: affected with urinary tract infection (UTI) and unaffected (control). Further, to determine the most common m...
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Objective: To determine the proportion of ultrasound abnormalities of the urinary system between two groups of children: affected with urinary tract infection (UTI) and unaffected (control). Further, to determine the most common microorganisms causing UTI in those children with urinary tract abnormalities.
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OBJECTIVE. Common fetal anomalies of the kidneys and urinary tract encompass a complex spectrum of abnormalities that can be detected prenatally by ultrasound. Common fetal anomalies of the kidneys and urinary tract can affect amn...
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OBJECTIVE. Common fetal anomalies of the kidneys and urinary tract encompass a complex spectrum of abnormalities that can be detected prenatally by ultrasound. Common fetal anomalies of the kidneys and urinary tract can affect amniotic fluid volume production with the development of oligohydramnios or anhydramnios, resulting in fetal pulmonary hypoplasia and, potentially, abnormal development of other fetal structures.
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Hematuria is a common clinical manifestation of diseases affecting the urinary system. Sometimes it may not represent any underlying disease and is of no clinical significance, especially when it is transient in young adult patien...
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Hematuria is a common clinical manifestation of diseases affecting the urinary system. Sometimes it may not represent any underlying disease and is of no clinical significance, especially when it is transient in young adult patients. However, it may represent underlying intrinsic kidney disease or malignancy in patients, even if transient. Therefore, detection of hematuria in the appropriate clinical setting and further investigation based on the individual clinical scenario helps establish correct diagnosis and guide further management. This article discusses the etiologies and workup of hematuria.
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This study was performed to evaluate the clinical course and renal outcome of patients with unilateral multicystic dysplastic kidney (MCDK). We retrospectively reviewed the medical records of 59 cases with MCDK followed at ?anli{d...
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This study was performed to evaluate the clinical course and renal outcome of patients with unilateral multicystic dysplastic kidney (MCDK). We retrospectively reviewed the medical records of 59 cases with MCDK followed at ?anli{dotless}urfa Children's Hospital between January 2009 and February 2013. The median age of the patients (boys 52.5%) was 31 months (range: 6-197) and the median follow-up period was 23 months (range: 6-111). Forty-two (71.2%) patients were diagnosed antenatally. The MCDKs were found more often on the right side (55.9%). The most frequently associated urological abnormality was contralateral vesicoureteral reflux (VUR) (26.6%). A total of 3 (5%) patients developed chronic renal insufficiency (CRI), 2 of whom had grade IV and V VUR; the other patient with CRI had a small and hyperechogenic contralateral kidney, suggesting dysplasia-hypoplasia, without any urological anomalies on imaging studies. The size of MCDK was unchanged in 20 (34%), had regressed in 26 (44%), and had increased in 9 (15.3%) patients. Total involution was documented in 4 (6.7%) patients. Compensatory hypertrophy occurred in 36/45 (80%) patients, with a mean age of 19.2±8.3 months. Proteinuria and hypertension were detected in 1 (1.7%) patient each. In conclusion, abnormalities in the contralateral kidney in patients with MCDK increase the risk of renal failure. An initial investigation for associated urinary tract malformations should be done and the growth and function of the contralateral kidney, hypertension, and proteinuria should be monitored in all children with MCDK.
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