congenital malformations of the urinary system
Introduction
Introduction to congenital urinary malformation Congenital urinary malformations are most common in the kidney and ureteral malformations. Common symptoms are hematuria, abnormal urination, abdominal pain, abdominal mass, complications and comorbidities. Urinary tract infections are the most common. Genital malformations refer to male genital malformations. Congenital malformations of female genitals, hypospadias in children. Repeated kidney, repeated ureter and ectopic ectopic is a clinically uncommon pediatric congenital malformation, but due to the large variation in clinical manifestations, it also brings certain difficulties to clinical diagnosis and treatment. At the 4th to 7th week of embryo, the ureter is from the kidney. Tube differentiation, the ureteral bud is emitted from the lower end of the middle kidney tube, and the upper end is developed upward to form a ureter. After entering the kidney tissue, the renal pelvis, renal pelvis and collecting system are gradually formed. If two ureteral buds or ureters are repeatedly deformed in the process. . basic knowledge The proportion of illness: 0.023% Susceptible people: no special people Mode of infection: non-infectious complication:
Cause
Congenital urinary tract malformation
Renal malformations include cystic nephropathy, hoof-shaped kidney, isolated kidney, etc. Congenital ureteral malformations are common, including complete ureteral defects, such as: ureteral malformation, ureteral bulging, ectopic ureteral opening, inferior vena cava ureter, ureter , the renal pelvis is connected to the external deformity.
Repeated kidney, repeated ureter and ectopic ectopic is a clinically uncommon pediatric congenital malformation, but due to the large variation in clinical manifestations, it also brings certain difficulties to clinical diagnosis and treatment. At the 4th to 7th week of embryo, the ureter is from the kidney. Tube differentiation, the ureteral bud is emitted from the lower end of the middle kidney tube, and the upper end is developed upward to form a ureter. After entering the kidney tissue, the renal pelvis, renal pelvis and collecting system are gradually formed. If two ureteral buds or ureters are repeatedly deformed in the process. .
Prevention
Congenital urinary malformation prevention
The disease is mainly congenital diseases, which may have certain correlation with genetic factors, mood and nutrition during pregnancy, so this disease cannot be directly prevented. Early detection, early diagnosis, and early treatment are important for preventing this disease. Regular examination should be done during pregnancy. If the child has a tendency to develop abnormalities, chromosome screening should be done in time, and abortion should be performed in time to avoid the birth of the diseased child.
Complication
Congenital urinary malformation complications Complication
Complications of congenital urinary malformations:
In view of the fact that the symptoms and hazards of congenital urinary tract malformation actually originate from complications, patients with asymptomatic and renal function can be treated without treatment, only follow-up observation; for those who have symptoms that affect renal function, they need treatment Surgery is the main treatment. The surgical plan should be determined according to the actual situation: if there is ureteral hydrops in the case of renal function, the kidney and ureter can be kept repeatedly, and only the ureteral replantation can be performed to solve the stagnant water. And the problem of reflux can be; if a ureteral cyst is combined, a smaller cyst (<3cm in diameter) can only cut the wall through the urethra (not too large, not to remove the wall multiple times) or the cyst to the top or Cut off horizontally.
Symptom
Congenital urinary tract malformation symptoms Common symptoms Hematuria with poor urination, dysuria, lower abdominal mass, abdominal pain, hematuria
Clinical manifestations of congenital urinary malformations:
(1) urinary incontinence is the main manifestation, caused by ectopic ureteral opening;
(2) The main manifestation of dysuria is caused by ureteral cysts;
(3) Mainly manifested by urinary tract infection, caused by urinary reflux and urinary tract water;
(4) The main manifestation of abdominal mass is caused by repeated kidney and repeated ureteral hydrops.
Examine
Examination of congenital urinary malformations
Digital rectal examination: It is an important test to provide important clues for determining the extent of urethral stricture and whether it is combined with rectal injury.
Diagnostic catheterization: It is still controversial, because it can make partial laceration become complete fracture and aggravate bleeding and easily cause secondary infection of hematoma.
A urethral metal probe or an induced strip test can determine the location and extent of urethral stricture.
Hematuria, liver and kidney function, electrolytes, ECG, chest X-ray, urology B ultrasound, bladder urethrography, KUB + IVU, endoscopy.
Diagnosis
Diagnosis and diagnosis of congenital urinary tract malformation
The lower end of the ureteral bud from the middle kidney tube is gradually connected to the bladder. When the diaphragm is finally formed, if the diaphragm is not absorbed or broken for some reason, it can cause stenosis, obstruction, and ureteral dilatation in the ureteral orifice. , the formation of ureteral cysts; another cause may be ureteral dysplasia, resulting in bladder ureteral mucosa relaxation, the formation of cysts, for the ureter does not enter the bladder, it can open in the vestibule, vagina, urethra, etc., manifested as enuresis. For men, if the ectopic opening is in the bladder neck, posterior urethra, seminal vesicle, ejaculatory duct and rectum above the external sphincter, there is no urinary symptoms at this time.
The ureter can enter the bladder separately, or merge into a ureter into the bladder at different parts, called the y-shaped ureter, which enters the ureter of the bladder respectively; the ureter from the lower kidney is normal, often without water, and its opening also enters from the normal site. The bladder; the ureter from the upper kidney often has water, and its entry into the bladder is also abnormal, often entering the bladder from the lower inner side of the normal ureteral orifice.
