The results of treatment of newborns with postrenal anuria due to upper urinary tract obstruction, caused by fungal bezoar
- Authors: Sizonov V.V1,2, Dubrov V.I3, Akramov N.R4, Markov N.V5, Kagantsov I.M6, Shidaev A.K.2
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Affiliations:
- Rostov Regional Pediatric Hospital
- FGBOU VO «Rostov State Medical University of the Ministry of Health of the Russian Federation
- Hospital No2, Minsk
- GBOU VPO Kazan State MedicaI University of the Ministry of HeaIth of the Russian Federation
- FGBOU VO Northern State MedicaI University
- Pitirim Sorokin Syktyvkar State University
- Issue: No 1 (2020)
- Pages: 81-85
- Section: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/312426
- DOI: https://doi.org/10.18565/urology.2020.1.81-85
- ID: 312426
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Abstract
Aim. To evaluate the results of different methods of urine derivation in patients with postrenaI anuria due to upper urinary tract (UUT) obstruction, caused by fungal bezoar. MateriaIs and methods. The resuIts of treatment of postrenal anuria in 8 patients without congenitaI obstructive anomaIies of UUT in 5 cIinics from 2004 to 2018 were anaIyzed. All patients from the birth received continuousIy two or more antibiotics for diseases not reIated to kidneys and the urinary tract. Median of gestational age was 32 weeks [31.5; 38.5]. There were 4 boys (50%), and 4 girls (50%). The duration of anuria at the time of hospitalization was 2 days [1.5; 5]. Creatinine level at admission was 218 μmol/l [164.5; 392.5] and urea was 17.9 μmol/l [13.2; 24.95]. In all cases, candida albicans was revealed in urine. Postoperative complications were graded according to the Clavien-Dindo classification. ResuIts. AII patients received systemic antifungaI therapy; UUT drainage was performed in 7 (87.5%) cases. Ureteral catheter was placed bilaterally in 2 (28.6%) patients (4 renal units). There were 5 complications (CIavien-Dindo grade IIIb). BiIateraI percutaneous nephrostomy was performed in 3 (42.8%) patients (6 renal units), and there were 2 complications (Clavien-Dindo grade Illb and V). Open pyelostomy was performed in 2 (28.6%) patients (one bilateral, one on the right side; a total of 3 renal units). There was only one complication of Clavien-Dindo grade V. The average number of surgical procedures required to alleviate UUT obstruction per one renal unit was as following: 2.25 for ureteral catheterization; 1.17 for percutaneous nephrostomy; 1 for open pyelostomy. Regardless of the drainage method, diuresis tended to be normalized and azotemia decreased during the first postoperative day. In one case, the obstruction was eliminated by antifungal therapy without drainage of UUT. Mortality rate was 25% (n = 2). Conclusion. Ureteral catheterization is a minimally invasive, safe method for decompression of UUT obstruction, caused by fungal bezoar, which is non-inferior to nephrostomy tube or open pyelostomy. Ureteral catheterization can be used as a primary method of urine derivation in children with UUT obstruction caused by candida bezoar
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About the authors
V. V Sizonov
Rostov Regional Pediatric Hospital; FGBOU VO «Rostov State Medical University of the Ministry of Health of the Russian Federation
Email: vsizonov@mail.ru
V. I Dubrov
Hospital No2, Minsk
Email: dubroff2000@mail.ru
N. R Akramov
GBOU VPO Kazan State MedicaI University of the Ministry of HeaIth of the Russian Federation
Email: aknail@rambler.ru
N. V Markov
FGBOU VO Northern State MedicaI University
Email: nikolarx@gmail.com
I. M Kagantsov
Pitirim Sorokin Syktyvkar State University
Email: ilkagan@rambler.ru
A. KH-A Shidaev
FGBOU VO «Rostov State Medical University of the Ministry of Health of the Russian Federation
Email: painkiller444@mail.ru
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