Intérêt diagnostique er thérapeutique de la cystoscopie en urologie pédiatrique au CHU de Sétif

Abstract

Introduction : Urethrocystoscopy is a modern tool, essential in pediatric endurology, it allows not only the exploration but also the treatment of certain condition of the lower urinary tract in children. This study aims to demonstrate the value of cystoscopy as an interesting diagnostic and therapeutic tool in pediatric urology. Material and method : This is a prospective observational descriptive single-center study involving 77 cases of urethrocystoscopy performed for the diagnosis or treatment of certain condition of the lower urinary tract of children, at the level of the pediatric surgery department, at the Sétif University Hospital, by the same operator, over a period of three and a half years, spanning the month of March 2020 to October 2023. All children and adolescents aged between 1 day and 18 years old, who present with a lower urinary tract condition were included. whether congenital or acquired, constituting an indication for urethrocystoscopy, for diagnostic or therapeutic purposes Results : The overall median age of our population is 44 months (07 days -15 years and 04 months) with variations depending on the pathology in question, 22% of patients were diagnosed antenatally. The overall sex ratio was 3 with a clear male predominance. 92.2% of cystoscopies were scheduled and 7.8% were performed as an emergency. 24.6% of cystoscopies were exploratory [RVU (02), RUA (01), dual system (03), suspicion of VUP (07), neurological bladder (01), tumor pathology (03), urachal fistula (01), post-traumatic urethral diverticulum (01)], and 72.7% were interventional [double J catheter removal (35), MUO dilatation (09), RVU (06), ureterocele (03), endoscopic realignment (03), VUP (01), stone extraction (01)]. Discussion : The safety of the procedure was observed in more than 83% of urethrocystoscopies, which took place without any major complications. The gain in terms of operating time was remarkable with an average duration for all pathologies combined of around 21.25 ± 26.07 min. the other gain was represented by the considerable shortening of the length of hospital stay, increasing to an average of .2.3 ± 5 days. The endoscopic procedure was successful in most of our patients. The success rate was 70% in endoscopic dilation, 87.5% in endoscopic injection, 66.66% in ureterocele incision, 33.33%. in endoscopic realignment, 100% in VUP section, 100% in stone extraction, and 94% for double J stents removal. Conclusion : We believe that the contribution of urethrocystoscopy is undeniable, because it is a safe and effective approach in the diagnosis and treatment of uropathy of the lower urinary tract in children.