Screening program for uro-genital congenital anomalies in children

Abstract

Aims. The aim of the study is the evaluation of the results of a screening pro-gram for the diagnosis of uro-genital congenital anomalies in a school-age population of children.

Patients and methods. Between 2005 and 2008 we initiated a screening pro-gram for uro-genital anomalies and we examined the children from 10 schools in Cluj, Sibiu and Mureş Counties. The evaluation included clinical examination and ultrasound evaluation of the kidneys and the urinary tract. The following parameters were assessed: presence, location and symmetry of size of the kidneys, the presence of hydronephrosis, dilatation of the ureters, post-void residual urine, and presence of the testicles in the scrotum, existence of phimosis and location of the urethral meatus.

Results. The screening of 1006 children (aged 5-18 years) yielded 93 (9.3%) patients with uro-genital anomalies. There were eight children diagnosed as having unilateral cryptorchism, eight unstable testes, 31 cases of phimosis or hypertrophy of the frenulum, eight hypospadias, five hydrocele, three children with bilateral cryptorchism and one case each with varicocele, micropenis and sperm cord cyst. The ultrasound evaluation revealed 14 duplex renal units without hydronephrosis, six cases of hydronephrosis, three cases of renal cysts, two cases of renal ectopia and two cases of unilateral renal agenesia. Surgical intervention was planned in 43 cases (4.3%).

Conclusions. Screening for uro-genital congenital anomalies using clinical examination and ultrasound is effective. The higher incidence of the genital abnormalities should draw the attention of the pediatricians upon the genitals during routine examinations.