ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Major technologic advances in diagnostic imaging continue to improve diagnostic accuracy in pediatric urology patients. Power Doppler ultrasound has been especially valuable in the evaluation of scrotal disease and may be useful in renal infections. Helical computed tomography offers advantages in the assessment of renal vascular architecture. Nevertheless, controversies in the evaluation of Wilms' tumor and urinary tract infections continue to generate as much heat as light as the role of new modalities is now under scrutiny.

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Our knowledge of the pathophysiology of pediatric voiding dysfunction is strengthened by urodynamic studies investigating common bladder problems in children. Natural filling urodynamics in infants and children are showing very high detrusor voiding pressures and a transient period of vesicourethral discoordination. Vesicoureteral reflux is often linked to high voiding pressure, especially in males, and the presence or absence of a pop-off has significant implications for long-term bladder function in boys with posterior urethral valves. The long-held theory of spinal reflex-mediated micturition in infants is questioned and new body surface area based nomograms for uroflowmetry in children are presented. This review illustrates the vital role urodynamic studies are playing in the diagnosis and treatment of vesicourethral dysfunction in children.

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Recent publications have focused on the incidence of vesico-ureteral reflux in children affected by other urinary tract malformations such as multicystic kidney and renal agenesis. Urodynamic evaluation may play an important role in understanding the pathophysiology of reflux. Many efforts have been made to try to optimize the results of both endoscopic and surgical treatment, minimizing, at the same time, patients' discomfort and costs. In this respect, endoscopic treatment and extravesical anti-reflux procedures seem to offer some minor advantages over the traditional intravesical procedures.

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Changes in volume and histology of the testis in adolescent varicocele is a dynamic and progressive process. Testicular damage of adolescent varicocele can be prevented by prophylactic surgery but not all adolescents with varicocele require such measures. However, semen analysis cannot serve as an indicator of damage in these patients, and size and symptoms are also not sufficient. Therefore both testicular volume and a gonadotropin-releasing hormone stimulation test are being used for early detection of testicular damage. Physical examination is the gold standard for the diagnosis of varicocele. Both gray-scale and colour Doppler sonography can be used as adjuncts. The operative techniques for varicocele are numerous, but can be categorized into retroperitoneal high ligation and artery-sparing inguinal ligation. Laparoscopic ligation is gaining popularity, and for selected cases interventional radiographic embolization can also be used. Currently no single or group of tests can accurately predict whether an adolescent with varicocele will be fertile. Thus, at least yearly follow-up of those patients who are not initially indicated for surgery should be recommended.

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Although experience with endourologic techniques in infants and children has lagged behind that of adults, the development of new purpose-designed instruments for use in small children has now allowed for some significant advances. Certainly, more noteworthy advances have been recorded in the laparoscopic literature with a wide number of procedures having been accomplished via laparoscopic techniques. Laparoscopic orchidopexy has emerged in many people's minds as a credible procedure, and there is increasing interest particularly in the USA among the pediatric urologic community and pediatric surgical community. The other significant advances deal with injectables. Now that collagen appears to be a safe, although perhaps not the optimal, injectable, there is increasing interest in the use of that substance for the correction of vesicoureteral reflux and incontinence owing to internal sphincter dysfunction. The use of endourology for valves has not changed much. There is some new instrumentation that may be significantly better. Likewise, incision of ureterocele is being accomplished with some enthusiasm at some centers, and doubt exists at other centers.

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0963-0643    

出版商:OVID    

年代:1996

数据来源: OVID