Contemporary aspects of diagnosis and treatment of abnormalitiesof theurinary tract in children
Congenital abnormalities of theurinary system in children are not only common pathology, but also, they have the tendency to their frequency increasing, notably at early childhood. Most urinary tract diseases are dangerous for the normal renal function, although they may not be detected without specific examinations. In the early years of life a child may not feel discomfort, and only in the age of 4-5 years revealed marked inconvertible reduction in kidney function. Clinical manifestations of urological diseases are varied in form, time of beginning and severity. Their assessment causes sometimes diagnostic difficulties and is accompanied by mistakes, because the symptoms are often not specific and inconstant.
In the last few years, due to the successes of prenatal diagnosis of defects, new branch of pediatric urology- neonatal urology – is developing. That is why the problem of early diagnosis of abnormalities of theurinary tractin first weeks and months of child’s life is actually.
Diagnosis ofabnormalities of theurinary system in newborns is multistage and is currently based on family history data, with consideration for individualities of pregnancy course, ultrasound data, and comprehensive physical examination, including the results of laboratory testing and the use of special techniques.
For the treatment of these complicated diseases in children contemporary urology uses minimally invasive technology - a complex of methods performed under the supervision of different methods ofmedical imaging: computed tomography and magnetic resonance imaging, endoscopy, ultrasound, use of special equipment and medical instruments to minimize significantly a surgical intervention. Due to introduction of endovideoscopic techniques into clinical urological practice an opportunity to overcome the major disadvantage of surgery - its aggressiveness and traumatizing effects- appeared. Less traumatic effect of a minimal access surgery was noticed by one of the greatest surgeons – Clermont; in 1928 he wrote: "Small incision is very constraint for surgeon, but is much more beneficial for patient in postoperative period." Currently, the benefits of minimally invasive technologies are not in doubt, and allow reducing hospital stay time and rehabilitation period.