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Fundamentals of practical urology of children's age.
Alexey Vladimirovich Lyuljko, Dmitry Diomidovich Murvanidze, Alexander Fedorovich Vozianov — 1984.
Anatomo-physiological features of bodies of urinogenital system at children, semiotics, all-clinical and radiological methods of research are covered in the manual. The etiology, a pathogeny, pathological anatomy, a clinical current, differential diagnosis, treatment and prevention practically of all urological diseases and anomalies which are found at children are described. Questions of urgent urology at acute insufficiency of kidneys, injuries of bodies of urinogenital system are considered, etc. The principles of surgical interventions on bodies of urinogenital system at children are stated.
For students of institutes of improvement of the doctors specializing in the field of children's urology. Can be useful to urologists, children's surgeons, pediatricians, radiologists.
Now more than 20% of all sick children have diseases of bodies of urinogenital system. It is also necessary to note that not less than a half of the adults having chronic diseases of bodies of urinogenital system for the first time got sick at children's age. Children with diseases of urinogenital system often long time are under supervision of pediatricians of whom only patients with visible anomalies or with the expressed dysfunctions of bodies of urinogenital system come into the view. Therefore for the solution of the problems connected with anomaly and pathology of kidneys, uric ways and generative organs at children efforts not only pediatricians, but also urologists, radiologists, surgeons, biochemists and other specialists are required. Rapid development for the last decade of urology and nephrology, accumulation of new data on physiology of urinogenital system at children, production of special tools and the equipment, achievements of anesthesiology caused need of training of specialists on children's urology, and also creations of specialized children's urology and nephrology units.
In the real grant attempt to generalize experience of the Soviet and foreign scientists in the field of diagnosis and treatment of diseases of bodies of urinogenital system at children, data of special pilot studies, and also long-term experience of the authors of a grant who are engaged in studying of this problem is made.
Along with anatomy and physiology of urinogenital system at children features of use of clinical and radiological methods of research are considered; much attention is paid to questions of ethnology, a pathogeny, clinic, diagnosis and treatment of urological diseases and anomalies of bodies of urinogenital system at children's age. For the first time material on rendering the acute urological management to children at injuries of bodies of urinogenital system, acute insufficiency of kidneys, acute inflammatory processes is given in literature. At the modern level the principles of surgical interventions on urinogenital bodies at children are stated.
Authors will be grateful to readers for all notes and wishes directed to improvement of this book.
ANOMALIES OF URIC SYSTEM
In medicine the term "anomaly" (Greek anomalia) is used for designation of the inborn resistant, usually not progressing deviation from normal structure and function of this or that body.
Anomalies of uric system have special value in view of the exclusive frequency — they make up to 35 — 40% of anomalies of all bodies and systems. In children's urological clinic patients meet such pathology in 30 — 35% of cases (according to our data — in 33%).
A big variety of anomalies causes the necessity to classify them. The classification given below essentially does not differ from standard though small amendments are introduced in it.
- Anomalies of quantity: agenesia of one or both kidneys; kidney hypoplasia; accessory kidney; doubling of a kidney.
- Anomalies of situation: a kidney allotopia in relation to skeletal educations; on the relation to each other; nephroptosis; wrong rotation of a kidney.
- Cystous and tubulo-medullary anomalies: polycystosis of kidneys, sponge kidney; simple cyst of a kidney; polymegacalycosis.
- Anomalies of a microstructure: a tubulopatiya with a polyuria, canalicular an osteopathy; a tubulopatiya with a nephrolithiasis; renal tubular acidosis.
- Anomalies of vessels of a kidney: verkhnepolyarny And nizhnepolyarny vessels, the intra renal drawing vessel, narrowing and aneurism of a renal artery.
- Inborn arteriovenous fistulas.
- Inborn changes of renal veins: anomalies of the right renal vein (multiple veins, falling of a yaichkovy vein into a renal vein on the right); anomalies of the left renal vein (ring left renal vein, retro aortal left renal vein, ekstrakavalny confluence of the left renal vein).
- Lokhanochno-chashechnaya system
Doubling and diverticulum of a pelvis, extrarenal pelvis and cup, cup allotopia.
- Anomalies of number: doubling of an ureter (full, incomplete, splitting of the lower part).
- Anomalies of situation (direction): cross allotopia of an ureter, retrocaval and retroiliakalny ureter.
- Anomalies of caliber: narrowing (single, multiple, in LMS, in PMS, on an extent), a spiral-shaped ureter.
- Anomalies of the termination: the ectopia is intravesical, narrowing of a vesical opening with the ureterotsel.
- Neuromuscular dysplasia (megaureter. ureter achalasia).
- Lower parts of uric ways
- Anomalies of a bladder: ekstrofiya, diverticulum, bladder neck contracture.
- Anomalies of an urethra:
narrowing, doubling, hypospadias, epispadiya, urethra valves, urethra diverticulum, hypertrophy of a seed hillock.