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[Fistulas of the lower urinary tract in children]
Luca Tonegatti1, Maria-Grazia Scarpa, Ilaria Goruppi
1S.C. Chirurgia e Urologia Pediatrica, Dipartimento di Pediatria - IRCCS Materno Infantile Burlo Garofolo, Trieste - Italy.
Insights
Pediatric lower urinary tract fistulas are rare abnormal connections requiring accurate diagnosis and classification. Surgical intervention is the primary treatment for these uncommon congenital or acquired conditions.
Area of Science:
- Urology
- Pediatric Surgery
- Medical Research
Background:
- Lower urinary tract fistulas are abnormal connections involving the bladder, urethra, and adjacent organs or skin.
- These fistulas can be congenital or acquired in children, with diverse etiologies including developmental defects, infections, tumors, radiation, and surgical complications like hypospadias repair.
Purpose of the Study:
- To review and consolidate knowledge on the classification, diagnosis, and treatment of pediatric lower urinary tract fistulas.
- To emphasize the importance of understanding etiology and classification for appropriate management of this uncommon pathology.
Main Methods:
- Conducted a PubMed literature search using keywords: lower urinary fistulae, urology, and pediatrics.
- Consulted medical textbooks and reviewed relevant selected articles.
- Focused the review on the classification, diagnosis, and treatment modalities of various fistula types.
Main Results:
- Paediatric lower urinary fistulas represent an uncommon but significant clinical challenge.
- Diagnosis relies on clinical presentation, signs, symptoms, and radiological or endoscopic examinations.
- Surgical treatment is the mainstay for the majority of these conditions.
Conclusions:
- Accurate recognition and classification of pediatric lower urinary fistulas are crucial for effective management.
- A thorough understanding of the etiology guides appropriate therapeutic strategies.
- Surgical correction remains the primary treatment approach for most pediatric urinary fistulas.
Abstract:
A lower urinary tract fistula consist in an abnormal connection between bladder, urethra and adjacent abdominal organs or skin. There are several types of urinary fistulas in paediatric age and they may be congenital or acquired. Etiology may be due to embriological defects, infectious processes, malignant tumours, pelvic irradiation as well as complications following surgical procedures, especially postsurgical repair of hypospadia or epispadia. Clinical presentation depends on the type of fistula and diagnosis is based on signs, symptoms and radiological or endoscopic examinations. We performed PubMed research using terms such as lower urinary fistulae, urology and paediatrics and we consulted medical texts. We reviewed selected articles and used the relevant ones to perform our study concentrating on classification, diagnosis and treatment of different types of fistulas. Paediatric lower urinary fistulas are an uncommon pathology, but the knowledge of their etiology and classification is important to recognise them and lead the physician to an appropriate treatment, which is surgical in most cases.
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