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Related Experiment Videos

VURD syndrome managed by pyelostomy.

Charles J Rosser1, Sam Auringer, R Lawrence Kroovand

  • 1Department of Urology, Bowman Gray School of Medicine Wake Forest University, Winston-Salem, North Carolina, USA.

Thescientificworldjournal
|September 7, 2004
PubMed
Summary
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Vesicoureteral reflux with upper urinary tract obstruction (VURD) syndrome in neonates may require proximal urinary diversion. A pyelostomy successfully stabilized creatinine levels in a neonate with severe VURD syndrome.

Area of Science:

  • Pediatric Urology
  • Neonatal Surgery
  • Nephrology

Background:

  • Congenital hydronephrosis diagnosed prenatally requires careful management in neonates.
  • Vesicoureteral reflux with upper urinary tract obstruction (VURD) syndrome presents a complex challenge in neonatal urinary tract management.

Observation:

  • A three-day-old neonate presented with hydronephrosis, elevated creatinine, and severe upper urinary tract dilation.
  • Despite initial lower tract drainage, the condition progressed, indicating a nonfunctioning kidney with severe vesicoureteral reflux.

Findings:

  • A left cutaneous pyelostomy was performed, diverting urine proximal to the obstruction.
  • Postoperatively, serum creatinine stabilized and significantly decreased, indicating improved renal function.

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Implications:

  • Proximal urinary diversion, such as pyelostomy, may be a crucial intervention for severe VURD syndrome when primary treatments fail.
  • This case highlights the importance of considering advanced surgical options for neonates with progressive hydronephrosis and renal compromise.