Apstrakt
Congenital genitourinary anomalies are common indications for surgery in children. Identification of factors that may result in poor surgical outcome could be critical to policy formulation in developing countries. The records of children managed with congenital genitourinary anomalies at the University of Benin Teaching Hospital between January 1999 and December 2006 were retrospectively studied. They were aged between 10 days and 14 years (mean 4.3 ± 6.7 years) with a male/female ratio 18.8:1, and accounted for 801 (57.1%) of all children managed with congenital anomalies. Lower tract lesions 796 (99.4%) due mainly to hernia/hydrocele [483 (60.3%)] accounted for the majority of cases, but 105 (13.1%) lesions comprising of 71 hydrocele and 34 undescended testes resolved spontaneously during follow-up without surgical intervention. Of the 696 (86.9%) children operated, delay in presentation which allowed irreversible complications to develop affected outcomes. Therefore, of 26 children with posterior urethral valves, 9 deaths due to chronic renal failure were recorded, and this accounted for all the mortality in this study. Chronic inflammation in extrophy of the bladder resulted in bladder plate fibrosis which made them inelastic and difficult to close with resultant failed repair and persistent urinary incontinence. Children with undescended testis that presented before age 5 years had a better outcomes than those who presented later as atretic testes requiring orchidectomy were recorded after age 5 years. Overall, 600 (86.21%) children had successful surgeries, while 87 (12.5%) were with residual functional impairments.
Keywords: Congenital, genitourinary, anomalies, 8-year, review.
Résumé
Les anomalies génito-urinaires congénitales sont des indications communes pour la chirurgie chez les enfants. L’identification des facteurs qui peuvent entrainer les résultants médiocres de la chirurgie peuvent être critique dans la formulation des politiques dans les pays sous développés. Les registres des enfants traites ayant de telles anomalies au Centre Universitaire Hospitalier de Benin entre janvier 1999 a Décembre 2006 étaient analysées dans une étude rétrospective. Ils étaient âgés de 10 jours – 14 ans (moyenne d’âgé 4.3 ± 6.7ans) avec une proportion male/female de 18.8:1, et s estimait pour 801 (57.1%) de tous les enfants traites de ces anomalies. Les lésions inferieures [796 (99.4%)] du principalement a l’hernie/hydrocèle [483 (60.3%)] estimait dans la majorité des cas, mais 105 (13.1%) des lésions y comprise 71 des hydrocèles et 34 testicules suspendus et non-descendant était guérit durant la période de suivi sans intervention chirurgicale. Sur les 696 (86.9%) enfants opérés, la présentation tardive avec des complications irréversibles affectaient les résultats. Ainsi, sur les 26 enfants ayant eu une valve urétrale postérieure, 9 mouraient due a une complication rénale sévère et représentait les cas de mortalité de cette étude. L’inflammation chronique de la vessie résultait à une fibrose de la plaque de la vessie non-élastique et difficile à fermer entrainant un échec de réparation et une inconsistance urinaire persistante. Les enfants ayant leurs testicules suspendus dans l’abdomen traites a moins de 5 ans avaient des résultats satisfaisant que ceux qui se présentaient tardivement nécessitant une orchidectomie. En tout 600 (86.21%) d’enfants ont eu une chirurgie avec succès alors que 87 (12.5%) avaient un mauvais fonctionnement résiduel.
Correspondence: Dr. O.D. Osifo, Paediatric Surgery Unit, Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria. E-mail: leadekso@yahoo.com
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