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Foreign bodies of the urinary tract in children: multicenter study DOI: 10.29188/2222-8543-2021-14-3-175-180
- Kagantsov I.M. – Dr. Sc., Chief Researcher, Research Laboratory for Surgery of Congenital and Hereditary Pathology Institute of Perinatology and Pediatrics, Almazov National Medical Research, Centre, Saint Petersburg, Russia, Professor at the Department of Surgical Diseases, Pitirim Sorokin Syktyvkar State University; Syktyvkar, Russia; https://orcid.org/0000-0002-3957-1615
- Sizonov V.V. – Dr. Sc., Assoc. Prof. (Docent); Prof., Dept. of Urology and Human Reproductive Health (with Pediatric Urology and Andrology Course), Rostov State Medical University; Rostov-on-Don, Russia, Pediatric Urological and Andrological Division, Rostov-on-Don Regional Children’s Clinical Hospital; Rostov-on-Don, Russia; https://orcid.org/0000-0001-9145-8671
- Shchedrov D.N. – PhD, Head, Urological Division, Yaroslavl Regional Pediatric Clinical Hospital; Yaroslavl, Russia; https://orcid.org/0000-0002-0686-0445
- Dubrov V.I. – PhD, Head, Urological Division, Minsk 2nd City Children Clinical Hospital; Minsk, Republic of Belarus; https://orcid.org/0000-0002-3705-1288
- Bondarenko S.G. – PhD; Head, Pediatric Urological Division, Volgograd Emergency Clinical Hospital No.7; Volgograd, Russia; https://orcid.org/0000-0002-1754-3365
- Akramov N.R. – Dr. Sc., Professor, Professor of the Department of Pediatric Surgery, Kazan State Medical University, Kazan, Russia, Chief Researcher of the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; Kazan, Russia; https://orcid.org/0000-0001-6076-0181
- Pirogov A.V. – PhD, Head, Pediatric Urological Division, State budgetary institution of health care of the Astrakhan region «Regional children’s clinical hospital named after N.N. Silishcheva»; Astrakhan, Russia; https://orcid.org/0000-0001-8031-2597
- Markov N.V. – PhD, Assoc. Prof. Dept. of Paediatric Surgery Northern State Medical University; Arkhangelsk, Russia; https://orcid.org/0000-0002-8807-2062
- Baranov Yu.V. – Pediatric urologist, Deputy Chief Physician for Surgery, Regional Children's Clinical Hospital; Ekaterinburg, Russia; https://orcid.org/0000-0002-2344-9324
- Svarich V.G. – Dr. Sc., Professor Dept. of Surgical Diseases, Pitirim Sorokin Syktyvkar State University, Syktyvkar, Russia, Head, Surgical Division, Syktyvkar Republican Children’s Clinical Hospital; Syktyvkar, Russia; https://orcid.org/0000-0002-0126-3190
- Cherepanov I.V. – pediatric urologist, Kostroma Regional children's Hospital; Kostroma, Russia; https://orcid.org/0000-0003-3650-1408
1115 Introduction. Urinary obstructions caused by foreign bodies (FB) represent quite a rare clinical case in practicе of pediatric urologists. However, some recent publications note a tendency towards higher occurrence of FB in urinary tracts in children. Most publications on FB urinary obstructions in children are devoted to the descriptions of individual medical cases. Considering the lack of multicenter research works on the problem, a study based on generalized clinical experience of several hospitals appears relevant.
Materials and methods. The study is based on retrospective analysis of treatment results of 44 pediatric cases from 10 clinics of Russia and Belarus during the period from 2000 through 2020. The study population comprised 28 (63.3%) boys and 16 (36.4%) girls. Mean age of the patients was 10.9±3.7 years. The children were subdivided into two groups: group I included 28 (63.3%) cases where FB had been introduced in the urethra or bladder by the child; group II included 16 (36.4%) cases where foreign bodies ended up in urinary tracts as a result of instrumental or surgical procedures.
Results. Clinical manifestation of FB was typical among the patients in the group I while in group II the condition more often occurred inapparently. Children often concealed FB introduction in the urinary tracts, and so contacts with a healthcare institution were ordinarily triggered by changes in urine analysis findings. Concealment of FB introduction in the urinary tracts determined help seeking start later than 7 days following the incident in 64.2% cases of group I. More than a half of the FB in children of group I were revealed within the first month after the incident. In group II, FB were revealed accidentally during follow-up examinations in 75% of the children. Transurethral FB extraction succeeded in 50% of the patients in group I. In group II, transurethral FB extraction was performed in 5 (31.3%) children. In 2 cases (12.5%), FB were extracted using flexible ureteroscopy. Percutaneous nephroscopy was used in 2 (12.5%) patients. 5 (31.3%) cases required pyelotomy with laparoscopic access, and in 2 (12.5%) patients a lumbotomy had to be carried out.
Discussion. The rarity of FB of the urinary tract in the practice of a pediatric urologist is the reason for the combination ofthe existing experience in providing medical care to children from 11 centers. Delayed demand for medical care was noted if FB were introduced by the child independently. The generalized material shows that in childhood, the same approaches to FB extraction are applicable as in adult patients; endoscopic FB removal is optimal.
Conclusions. In most cases of children suffering from foreign bodies in urinary tracts, the FB can be extracted using endoscopy without complications and with favourable outcome
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