Miklos Romics1, Geza Tasnadi2, Balint Sulya3, Andras Kiss3, Miklos Merksz3, Peter Nyirady4. 1. Department of Urology and Urooncology, Semmelweis University, Ulloi Str 78/b, Budapest, 1082, Hungary. miklos_romics@gmx.com. 2. Department of Surgery, Heim Pál Children's Hospital, Budapest, Hungary. 3. Department of Urological Surgery, Heim Pál Children's Hospital, Budapest, Hungary. 4. Department of Urology and Urooncology, Semmelweis University, Ulloi Str 78/b, Budapest, 1082, Hungary.
Abstract
OBJECTIVES: To collect and review the diagnostic and therapeutic solutions for primary and congenital lymphovascular malformations leading to urological symptoms in childhood and also to find the most efficient therapeutic algorithms managing such conditions. METHODS: In our work, we assemble all the diagnostic and therapeutic tools for lymphovascular malformations with urological-urogenital symptoms and demonstrate the interventional therapeutic algorithms through two of our cases where surgery (laparoscopic intervention and clipping of the lymph vessel) had to be performed to stop lymphoid leakage and restore anatomy. RESULTS: In cases, where lymphovascular malformations and urological-urogenital symptoms are both present, therapeutical success is graded by Browse's scoring system. According to that, our choices of management achieved the best possible outcome in both cases below. CONCLUSIONS: Although conservative ways of therapy are known and widely used, in more advanced cases surgical help is often needed to reach long-term improvement. In situations where significant mass of chyle has accumulated causing severe complaints, conservative therapy should not to be started. Surgical solutions provide fast and lasting improvement for patients suffering from congenital lymphovascular malformations.
OBJECTIVES: To collect and review the diagnostic and therapeutic solutions for primary and congenital lymphovascular malformations leading to urological symptoms in childhood and also to find the most efficient therapeutic algorithms managing such conditions. METHODS: In our work, we assemble all the diagnostic and therapeutic tools for lymphovascular malformations with urological-urogenital symptoms and demonstrate the interventional therapeutic algorithms through two of our cases where surgery (laparoscopic intervention and clipping of the lymph vessel) had to be performed to stop lymphoid leakage and restore anatomy. RESULTS: In cases, where lymphovascular malformations and urological-urogenital symptoms are both present, therapeutical success is graded by Browse's scoring system. According to that, our choices of management achieved the best possible outcome in both cases below. CONCLUSIONS: Although conservative ways of therapy are known and widely used, in more advanced cases surgical help is often needed to reach long-term improvement. In situations where significant mass of chyle has accumulated causing severe complaints, conservative therapy should not to be started. Surgical solutions provide fast and lasting improvement for patients suffering from congenital lymphovascular malformations.
Authors: M White; P R Mueller; J T Ferrucci; R J Butch; J F Simeone; C C Neff; I Yoder; N Papanicolaou; R C Pfister Journal: AJR Am J Roentgenol Date: 1985-11 Impact factor: 3.959