Why and when to lead a child to a pediatric urologist?

Zdorovye - - NEWS -

Many believe that a urologist is a doctor who is engaged in masculine health. This is correct, but only in part, because urological diseases can affect both young children and adolescents. About what is children's urology, what to draw attention to parents, what methods of treatment are being used today, we talk with the leading children's doctor-urologist of the Medical Network "Dobrobut" Maxim Ponomarenko.

Maxim Viktorovich, what is children's urology?

Pediatric and adolescent urology is a medical field that deals with various disorders of the urinary system and anomalies of the external genital organs in both boys and girls. We help our young patients with diseases of the upper urinary tract (kidney, ureter), as well as the lower urinary tract, such as the bladder and urethra. We treat patients with various abnormalities in the development of external genital organs in both boys and girls.

How do parents understand that a child needs help from a urologist? What should I look for?

I will enumerate literally the points when it is necessary to contact a pediatric urologist as soon as possible. - Painful urinary frequency in the child, day or night urinary incontinence (enuresis).

- Changes in the results of urine tests - an increase in the level of leukocytes.

- Unexplained fever.

- Pain in the lumbar region or abdomen.

- Color changes, unpleasant smell of urine.

- Boys: scrotum asymmetry (increase or decrease); phimosis (narrowing of the foreskin).

If at least one of the listed symptoms is present, it is necessary to show the child to the children's urologist.

With regard to urinary incontinence (day or night), then urination disorders in childhood, especially up to two years, usually do not take seriously, because this is a natural process in children. But after two years worth paying attention to this problem. Limit, which defines incontinence as a disease - over 5 years.

What specific diseases determines and cures the child's urologist?

Thanks to modern diagnostics, it is now possible to prevent or identify early congenital diseases of the genitals and urinary system. The specialist will conduct diagnostics and determine the indications for surgical treatment: with congenital and acquired defects of the upper urinary tract, including the bladder (hydronephrosis, megaureter, ureterocele); with congenital anomalies of external genital organs; inguinal and inguinal and scrotal hernias; the dropsy, cysts of the spermatic cord; varicocele, phimosis, cryptorchidism in boys.

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What methods are used to treat urological diseases in children?

We carry out both medication and surgical treatment. Depending on the case in surgical treatment, we perform:

- low-traumatic laparoscopic operations (without incisions);

- Оpen operations with minimal cuts;

- Plastic and reconstructive operations of the genitals.

Parents always experience if the child is to be treated surgically. Whether it will hurt, how quickly the wound will heal, when the body recovers - these questions are most of all worried by moms and dads. We can reassure parents. For us, the main thing is that the child is not afraid of anything, so that a small patient and his parents trust the doctor. The child will not have any pain during the operation (adequate anesthesia, experienced anesthetists), or in the postoperative period (no trauma, no large incisions). Dad or mother nearby - for the child this is confidence in their own safety. In our clinic, all conditions for the hospitalization of children with their parents in comfortable conditions are created. The condition of the child is under the control of doctors and nurses. A small patient is constantly surrounded by care. Doctors are always in touch, answer any questions, provide peace to parents and children.

When surgical treatment apply so-called. "Small" anesthesia - a short medication sleep. Awakening after such anesthesia is easy, without side effects. There is no need for a long postoperative period. In most cases, it is enough for a child to spend several hours in the hospital, and parents can take him home.

How not to miss the onset of the disease? What do you recommend to parents?

Be attentive to your children. Virtually every third child suffers from abnormalities of the genitourinary system, and often a late referral to a specialist is the cause of a complex course of the disease, when long-term and serious treatment is required. At the same time, if the disease is detected at an early stage, in the vast majority of cases it is successfully cured.

In addition, many urological diseases in children are asymptomatic, without any changes in the composition of urine and without visible anomalies in the structure of the genital organs. In such cases, deviations from the norm can only be detected using instrumental diagnostic methods. Therefore, we recommend: children after birth and at the age of 1 year to undergo ultrasound of the kidneys and bladder; do urine analysis before important events in the life of the child - the year from the date of birth, vaccinations, admission to school. Boys at the age of one year, as well as after reaching the age of 12-13, must undergo an examination by a urologist.

It is very important to identify the disease at an early stage and start treatment on time. The earlier the better!

If you find a pathology in the child, behave as calmly as possible so as not to disturb the normal psychological situation in the family. The urological room of our clinic provides a full range of diagnostic and treatment procedures. And pediatric urologists will always find the right solution for treating your child.

Рас­ска­жи­те о ра­ке гор­та­ни, что это та­кое?

Рак гор­та­ни яв­ля­ет­ся наи­бо­лее рас­про­стра­нён­ной зло­ка­че­ствен­ной опу­хо­лью гор­та­ни — 50-60 % слу­ча­ев. Он со­став­ля­ет око­ло 3 % от всех зло­ка­че­ствен­ных опу­хо­лей че­ло­ве­ка. Пре­иму­ще­ствен­но встре­ча­ет­ся у муж­чин 40-60 лет, ко­то­рые со­став­ля­ют 80-95 % боль­ных.

Как рас­по­знать за­бо­ле­ва­ние гор­та­ни?

Ес­ли че­ло­век раз­го­ва­ри­ва­ет сип­лым го­ло­сом, несколь­ко ме­ся­цев ка­шель и хри­по­та, вос­па­ли­тель­ные про­цес­сы схо­жие с ан­ги­ной, сле­ду­ет об­ра­тить­ся к ЛОР вра­чу, для кон­суль­та­ции и на­зна­че­нии ле­че­ния. В дан­ное вре­мя, вы­бор спе­ци­а­ли­стов сто­ит ост­ро, так как нет необ­хо­ди­мо­го обо­ру­до­ва­ния для ди­а­гно­сти­ро­ва­ния и спе­ци­а­ли­стов для об­ласт­но­го и рай­он­но­го ле­че­ния. Что­бы вы­явить за­бо­ле­ва­ние на пер­вом эта­пе ди­а­гно­сти­ки, это сей­час за­пре­дель­но, так как про­сто нет та­ко­го ко­ли­че­ства спе­ци­а­ли­стов.

Встре­ча­ют­ся ли фак­то­ры рис­ка при за­бо­ле­ва­нии?

Ча­ще все­го рак гор­та­ни (рак ро­то­глот­ки, опу­холь гор­ла) встре­ча­ет­ся у ку­ря­щих лю­дей. Чем боль­ше стаж ку­ре­ния, тем вы­ше у ку­риль­щи­ка риск за­бо­леть ра­ком гор­та­ни. По­вы­шен­ный риск при зло­упо­треб­ле­нии ал­ко­го­лем. В груп­пе рис­ка на­хо­дят­ся лю­ди со сла­бой им­мун­ной си­сте­мой – с врож­ден­ны­ми за­бо­ле­ва­ни­я­ми, ВИЧ ин­фи­ци­ро­ван­ные. Уве­ли­чи­ва­ет риск кон­такт с вред­ны­ми хи­ми­че­ски­ми ве­ще­ства­ми, та­ки­ми как дре­вес­ная пыль, крас­ки, ла­ки и др.

Рас­ска­жи­те о клас­си­фи­ка­ции ра­ка гор­та­ни и ме­то­дов ле­че­ния?

I ста­дия — опу­холь огра­ни­чи­ва­ет­ся сли­зи­стой обо­лоч­кой и под­сли­зи­стым сло­ем, на­хо­дит­ся в пре­де­лах од­но­го от­де­ла гор­та­ни; ме­та­ста­зов нет. II ста­дия — опу­холь за­ни­ма­ет весь от­дел гор­та­ни, но не вы­хо­дит за его пре­де­лы; ме­та­ста­зов нет.

III ста­дия — опу­холь про­рас­та­ет за пре­де­лы од­но­го от­де­ла гор­та­ни на со­сед­ние тка­ни, вы­зы­вая непо­движ­ность по­ло­ви­ны гор­та­ни, но не рас­про­стра­ня­ет­ся на со­сед­ние от­де­лы.

IV ста­дия — опу­холь про­рас­та­ет в со­сед­ние ор­га­ны. На пер­вой и вто­рой ста­дии ис­поль­зу­ет­ся лу­че­вая те­ра­пия. Вме­сте с об­лу­че­ни­ем ос­нов­ной опу­хо­ле­вой мас­сы про­во­дят об­лу­че­ние и ме­та­ста­зов. Ино­гда тре­бу­ет­ся несколь­ко се­ан­сов об­лу­че­ния. На по­сле­ду­ю­щих ста­ди­ях про­во­дит­ся пред­ва­ри­тель­ная лу­че­вая те­ра­пия, во вре­мя ко­то­рой об­лу­ча­ет­ся вся шея. Че­рез 3-4 неде­ли вы­пол­ня­ет­ся ра­ди­каль­ная опе­ра­ция (ре­зек­ция гор­та­ни, ла­ринг­эк­то­мия, рас­ши­рен­ная ла­ринг­эк­то­мия), од­но­вре­мен­но с ко­то­рой уда­ля­ют­ся и ре­ги­о­нар­ные ме­та­ста­зы.

Что та­кое го­ло­со­об­ра­зу­ю­щая опе­ра­ция?

По­сле ра­ди­каль­ной опе­ра­ции в пла­но­вом по­ряд­ке вы­пол­ня­ет­ся хи­рур­ги­че­ская ре­кон­струк­ция гор­та­ни с пла­сти­кой го­ло­со­вых свя­зок. Это поз­во­ля­ет вос­ста­но­вить раз­де­ли­тель­ную функ­цию гор­та­ни (меж­ду пи­ще­ва­ри­тель­ным трак­том и тра­хе­ей), предот­вра­тить хро­ни­че­скую ас­пи­ра­цию пи­щи и вос­ста­но­вить го­лос. Од­на­ко ис­поль­зу­ют­ся та­кие опе­ра­ции лишь по­сле то­го, как по­лу­че­ны все дан­ные о том, что рак из­ле­чен и нет ве­ро­ят­но­сти ре­ци­ди­ва па­то­ло­гии. Так­же в даль­ней­шем ис­поль­зу­ют­ся го­ло­со­об­ра­зу­ю­щие ап­па­ра­ты. Це­на та­ко­го ап­па­ра­та со­став­ля­ет 800 ев­ро, ме­нять сле­ду­ет в те­че­ние де­вя­ти ме­ся­цев.

Ка­кой про­дол­жи­тель­ный срок жиз­ни при за­бо­ле­ва­нии?

Ес­ли че­ло­век об­ра­ща­ет­ся с пер­вой-вто­рой ста­ди­ей это 85-96% у него есть око­ло пя­ти лет жиз­ни. Ес­ли тре­тья и чет­вер­тая сте­пень 33-65% жиз­ни.

Ваш со­вет на­шим чи­та­те­лям?

Не на­до пу­гать­ся за­бо­ле­ва­ний, это все ле­чить­ся, это все воз­мож­но. Глав­ное во­вре­мя об­ра­тить­ся за по­мо­щью к спе­ци­а­ли­сту. Тым­чук Сер­гей Ни­ко­ла­е­вич док­тор ме­ди­цин­ский на­ук, за­слу­жен­ный врач Укра­и­ны за­ве­ду­ю­щий от­де­ле­ни­ем ото­ла­рин­го­ло­гии №2 (он­ко­ло­ги­че­ское) Дне­про­пет­ров­ская кли­ни­че­ская боль­ни­ца им. Меч­ни­ко­ва г. Дне­пр, Дне­про­пет­ров­ская обл. тел. от­де­ле­ния: +38(0562) 47-14-27

Medical network "Dobrobut" Kyiv, Victory 41a Avenue, Kyiv + 380 (67) 238 64 92+ 38 (044) 495-28-88 dobrobut.com

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