[Diuretic radionuclide nephrography in the diagnosis of obstruction of the upper urinary tract in children].
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Biomedical subjects
Publications and source records attributed to R Kocvara.
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During 8 years in the department of paediatric urology of the Clinic of Urology of the Charles University Prague 267 children with a vesicoureteral reflux (VUR) aged between 6 months and 15 years were operated. The sex ratio girls to boys was 4.5 to 1.0. At 89% an infection of the urinary tract was simultaneously present. On an average first symptoms appeared at the age of 3 1/2 years. The operative therapy was performed at the of 6. 221 children with 340 reflux units underwent an after examination 3 to 12 months after operation. Most frequent were the degrees of reflux II and III with altogether 82%. 255 vesicoureteral refluxes were primary refluxes and 85 secondary ones. 208 reflux ureters were modified after Politano-Leadbetter, 105 modified after Gil-Vernet, 17 were treated in form of a pyeloureter anastomosis and 10 by means of nephroureterectomy. A persisting post-operative infection of the urinary tract was existing in 14.5% after 3 months and in 8.8% after 1 year. Implantation stenoses appeared in 2.4% and were successfully reoperated. Altogether the healing of the reflux was successful in 96.4%. An early operative therapy and in refluxes of second and third degree the modified method according Gil-Vernet are recommended.
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