Summary of the Urology Section

At the recent annual meeting of the American Academy of Pediatrics in Dallas, Texas, October 22-24, 1994, the Section of Urology conducted its scientific program. One hundred twenty-seven abstracts were presented. The meeting was presided over by Richard Ehrlich, MD, from Los Angeles, California, the chairperson of the Section of Urology. This article summarizes papers of interest to practicing pediatricians. CONGENITAL HYDRONEPHROSIS Clinical Papers The evaluation and management of antenatal hydronephrosis continue to be controversial for pediatric urologists. Wiener et al from Duke University, attempted to determine if prenatal ultrasounds have resulted in overdiagnosis of UPJ obstruction. They reviewed the incidence of pyeloplasties performed during a 20-year period. Although the age of presentation and treatment of UPJ obstruction has progressively decreased, the overall incidence of surgery performed has remained unchanged. This suggests that prenatal ultrasound does not lead to excessive diagnosis of UPJ obstruction. Along the same lines, Lakhoo et al, from Leeds UK, reported that infection- related morbidity secondary to congenital renal anomalies cannot be entirely prevented by the widespread application of prenatal ultrasound. Fifty children with renal abnormalities developed urinary tract infections. In more than 50% of cases, the anomaly was not detected on antenatal study. In an additional 30% of patients, the anomaly was detected on the ultrasound, but the patient developed urinary infection despite appropriate postnatal management. Less commonly, infection was related to inappropriate management of the antenatally detected anomaly. A few reports have attempted to correlate the degree of prenatal urinary tract dilation with postnatal outcome.1