Christina Granéli1, Hedda Marschall Sima2, Anna Börjesson2, Kristine Hagelsteen2, Einar Arnbjörnsson2, Pernilla Stenström2. 1. Department of Pediatric surgery, Skane University Hospital Lund, Institution of Clinical Sciences, Department of Pediatrics, 221 85 Lund, Sweden. Electronic address: christina.graneli@med.lu.se. 2. Department of Pediatric surgery, Skane University Hospital Lund, Institution of Clinical Sciences, Department of Pediatrics, 221 85 Lund, Sweden.
Abstract
BACKGROUND/ PURPOSE: Urinary tract function in children with Hirschsprung disease (HD) is rarely considered. AIM: to evaluate the prevalence of urinary tract anomalies and dysfunction in children with HD compared to controls. METHODS: This was an observational cross sectional case-control study. Children with HD who underwent transanal endorectal pull-through technique (TERPT) from 2005 to 2017 were invited to participate. Ultrasound of the urinary tract was performed postoperatively. Children >4 years were asked to answer a urinary tract function questionnaire. Controls were age-matched healthy children. Ethical approval was obtained. RESULTS: Seventy two children with HD and TERPT were included. Ultrasound was performed in 58 children (83%) post-TERPT. Ten anomalies were diagnosed in six children (10%). Structural anomalies included abnormal kidney size (7%), renal agenesis (2%), prominent calyces (2%) and renal pelvis anomaly (25). Probable acquired anomalies included hydronephrosis (2%), hydroureter (2%) and parenchymal damage (2%). One child had a prior nephrectomy owing to a Wilms' tumor. All 37 children >4 years (27 boys and 10 girls), median aged 8 years (range 4-12), answered the questionnaire as did 284 healthy controls (144 boys and 140 girls). Boys with HD reported a higher frequency of enuresis: 65% versus 9% (p = 0.001) and urinary tract infections: 18% versus 3% (p = 0.012). Girls with HD reported enuresis more frequently (60%) than healthy girls (7%) (p = 0.001). Children with HD with constipation reported enuresis more frequently (p = 0.038). CONCLUSIONS: Urinary tract anomalies and dysfunction deserve attention in the follow-up of children with HD. We suggest screening for urinary tract anomalies and urinary tract symptoms in follow-up of children with HD. TYPE OF STUDY: Treatment study. LEVEL: III.
BACKGROUND/ PURPOSE: Urinary tract function in children with Hirschsprung disease (HD) is rarely considered. AIM: to evaluate the prevalence of urinary tract anomalies and dysfunction in children with HD compared to controls. METHODS: This was an observational cross sectional case-control study. Children with HD who underwent transanal endorectal pull-through technique (TERPT) from 2005 to 2017 were invited to participate. Ultrasound of the urinary tract was performed postoperatively. Children >4 years were asked to answer a urinary tract function questionnaire. Controls were age-matched healthy children. Ethical approval was obtained. RESULTS: Seventy two children with HD and TERPT were included. Ultrasound was performed in 58 children (83%) post-TERPT. Ten anomalies were diagnosed in six children (10%). Structural anomalies included abnormal kidney size (7%), renal agenesis (2%), prominent calyces (2%) and renal pelvis anomaly (25). Probable acquired anomalies included hydronephrosis (2%), hydroureter (2%) and parenchymal damage (2%). One child had a prior nephrectomy owing to a Wilms' tumor. All 37 children >4 years (27 boys and 10 girls), median aged 8 years (range 4-12), answered the questionnaire as did 284 healthy controls (144 boys and 140 girls). Boys with HD reported a higher frequency of enuresis: 65% versus 9% (p = 0.001) and urinary tract infections: 18% versus 3% (p = 0.012). Girls with HD reported enuresis more frequently (60%) than healthy girls (7%) (p = 0.001). Children with HD with constipation reported enuresis more frequently (p = 0.038). CONCLUSIONS:Urinary tract anomalies and dysfunction deserve attention in the follow-up of children with HD. We suggest screening for urinary tract anomalies and urinary tract symptoms in follow-up of children with HD. TYPE OF STUDY: Treatment study. LEVEL: III.
Authors: Marina L Reppucci; Lea A Wehrli; Duncan Wilcox; Jill Ketzer; Alberto Pena; Luis de la Torre; Andrea Bischoff; Dan Wood Journal: Pediatr Surg Int Date: 2022-09-23 Impact factor: 2.003