비뇨기과적 관점에서 분석한 배설강존속증을 가진 환아들의 임상적 특징
Clinical Characteristics of Children with Persistent Cloaca: A Urological Perspective
방우진, 한상원, 이혜영,
소속 상세정보
방우진 ( Bang Woo-Jin )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
한상원 ( Han Sang-Won )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
이혜영 ( Lee Hye-Young )
연세대학교 의과대학 비뇨기과학교실
KMID : 0358320080490010077
Abstract
Purpose: Persistent cloaca is a rare multiple anomalous condition which involves the gastrointestinal, neurological and urogenital systems. We evaluated the clinical characteristics and urogenital anomalies of patients with persistent cloaca, and we investigated the factors that must be considered from a urological perspective.
Materials and Methods: We retrospectively reviewed the medical records of 11 patients who were diagnosed with persistent cloaca at our institution during the last 7 years.
Results: Nine of the 11 patients who were followed up at the urology clinic were subjected to this study. Nonspecific abnormalities, such as antenatal hydronephrosis, were noted in 5 of 9 patients. The chief complaints upon visits to the urologic clinic were recurrent urinary tract infections in 3, preoperative evaluation before neurosurgery in 3, urinary incontinence in 1, urinary retention in 1 and an elevated creatinine level in 1. The urological anomalies included 2 cases of renal agenesis and 1 horseshoe kidney. Vesicoureteral reflux was noted in 6 patients, and 4 of these patients underwent antireflux surgery. Videourodynamic study was performed in 8 patients and all of them were diagnosed with neurogenic bladder. Currently, 5 children are on intermittent catheterization, 2 have undergone vesicostomy and 2 void spontaneously.
Conclusions: Most patients with persistent cloaca had urological anomalies of the upper urinary tract and neurogenic bladder. Therefore, a multidisciplinary approach for diagnosis and treatment from various departments, including the urology, pediatric surgery, neurosurgery departments is mandatory.
키워드
Cloaca;Urogenital abnormalities
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