A Four-Year Review of Pediatric Urology Cases at the Philippine General Hospital

A Four-Year Review of Pediatric Urology Cases at the Philippine General Hospital
Title:A Four-Year Review of Pediatric Urology Cases at the Philippine General Hospital
Francis Raymond P. Arkoncel, MD; Marie Carmela M. Lapitan, MD and Telesforo E. Gana Jr., MD

Division of Urology, Department of Surgery, Philippine General Hospital, University of the Philippines Manila

Objective: To describe the characteristics of pediatric urologic cases seen by the Division of Urology, Philippine General Hospital, a tertiary government teaching hospital.

Methodology: This retrospective study was done on in-hospital patients of the Urology Service with ages ranging from birth to 18 years old from July 1, 2003 to June 30, 2007. The parameters studied were age, gender, admitting service, diagnosis, type of intervention received and outcome.

Results: There were 418 cases, representing 9 percent (418/4616) of the total inpatient population of Urology. The mean age was 8.17 years old (SD 5.47). The most common age group was the pre-school age (2-6 years old) comprising 28.9 percent (121/418). There were three times as many males as there were females. Almost half of patients (199/418, 47.6%) consulted for congenital anomalies. The most common congenital anomalies identified were uteropelvic junction (UPJ) stenosis (47/199, 23.6%), hypospadias (47/ 199, 23.6%), primary vesicoureteral reflux (VUR) (21/199, 10.6 %,) and inguinal hernia (20/199, 10%). For genitourinary trauma, the most common organ affected was the kidney (10/37, 27%), followed by the urethra (9/37, 24.3%), urinary bladder (8/37, 21.6%) and scrotum (8/37, 21.6%). Stones in the genitourinary tract were most commonly found in the urinary bladder (14/24, 58.3%). There were more primary urologic tumors than non-urologic tumors affecting the genitourinary tract (GUT) (12 vs. 8). Among the primary urologic tumors, the most common primary organ is the urinary bladder (5/12, 41.7%). Most of the patients underwent surgery (349/418, 83.5%), with open surgery still the most common form of operation (304/366, 83%). The most common operations were tenckhoff catheter insertions/removals (83/366, 22.7%), hypospadias repair (42/366, 11.5%), inguinoscrotal operations [herniorrhaphy, herniotomy, orchidopexy, orchiectomy, varicocoelectomy] (40/366, 10.9%) and percutaneous tube nephrostomy insertion (22/366, 6%). The most common type of hypospadias repair is the Snodgrass technique (17/42, 40.5%).

Conclusion: The characteristics of pediatric patients seen by the Division of Urology have been presented. Most of the data were consistent with the literature.

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