Surgical Procedures and Indications for Surgery

  • Annette Schröder
  • Wolfgang H. RöschEmail author
Part of the Medical Radiology book series (MEDRAD)


Often, the decision-making process with regard to indications for surgery is based on clinical findings in combination with the results of radiological imaging. However, sometimes an identical radiological finding will lead to surgery in one patient, and not in another, depending on clinical or other findings. Regardless, in many urological conditions, the results of the radiological tests are indispensable contributions to the decision whether to take the child to the operation room or not. Knowledge of the disease, indications for surgery, and the respective surgical procedure (or conservative management) will help to understand what one is actually looking for and facilitate interpretation and presentation of the radiological findings by the radiologist before and after surgery. This chapter will give an overview of the most commonly seen urological conditions in children that may require surgical correction, the key exams, and findings that lead to an operation, as well as respective surgical procedures and the expected radiological findings during follow-up.


  1. Al-Qudah HS, Santucci RA (2006) Complications of renal trauma. Urol Clin North Am 33:41–53, vi. doi: 10.1016/j.ucl.2005.10.005 CrossRefPubMedGoogle Scholar
  2. Anderson JC, Hynes W (1951) Plastic operation for hydronephrosis. Proc R Soc Med 44:4–5PubMedPubMedCentralGoogle Scholar
  3. Boone TB, Gilling PJ, Husmann DA (1993) Ureteropelvic junction disruption following blunt abdominal trauma. J Urol 150:33–36CrossRefPubMedGoogle Scholar
  4. Brown SL, Hoffman DM, Spirnak JP (1998) Limitations of routine spiral computerized tomography in the evaluation of blunt renal trauma. J Urol 160:1979–1981CrossRefPubMedGoogle Scholar
  5. Cabezali D, Maruszewski P, López F et al (2013) Complications and late outcome in transperitoneal laparoscopic heminephrectomy for duplex kidney in children. J Endourol 27:133–138. doi: 10.1089/end.2012.0379 CrossRefPubMedGoogle Scholar
  6. Chertin B, Pollack A, Koulikov D et al (2008) Long-term follow up of antenatally diagnosed megaureters. J Pediatr Urol 4:188–191. doi: 10.1016/j.jpurol.2007.11.013 CrossRefPubMedGoogle Scholar
  7. Cohen MH, Rotner MB (1969) A new method to create a submucosal ureteral tunnel. J Urol 102(5):567–568CrossRefPubMedGoogle Scholar
  8. Ellerker AG (1958) The extravesical ectopic ureter. Br J Surg 45:344–353CrossRefPubMedGoogle Scholar
  9. Gregoir W (1964) The surgical treatment of congenital vesico-ureteral reflux. Acta Chir Belg 63:431–439PubMedGoogle Scholar
  10. Hendren WH (1969) Operative repair of megaureter in children. J Urol 101:491–507CrossRefPubMedGoogle Scholar
  11. Holmdahl G, Brandström P, Läckgren G et al (2010) The Swedish reflux trial in children: II. Vesicoureteral reflux outcome. J Urol 184:280–285. doi: 10.1016/j.juro.2010.01.059 CrossRefPubMedGoogle Scholar
  12. Hoover DL, Duckett JW (1982) Posterior urethral valves, unilateral reflux and renal dysplasia: a syndrome. J Urol 128:994–997CrossRefPubMedGoogle Scholar
  13. Kaliciński ZH, Kansy J, Kotarbińska B, Joszt W (1977) Surgery of megaureters – modification of Hendren’s operation. J Pediatr Surg 12:183–188CrossRefPubMedGoogle Scholar
  14. Kielar AZ, Shabana W, Vakili M, Rubin J (2012) Prospective evaluation of Doppler sonography to detect the twinkling artifact versus unenhanced computed tomography for identifying urinary tract calculi. J Ultrasound Med 31:1619–1625CrossRefPubMedGoogle Scholar
  15. Koff SA, Mutabagani KH, Jayanthi VR (2002) The valve bladder syndrome: pathophysiology and treatment with nocturnal bladder emptying. J Urol 167:291–297CrossRefPubMedGoogle Scholar
  16. Kolon TF, Herndon CDA, Baker LA et al (2014) Evaluation and treatment of cryptorchidism: AUA guideline. J Urol 192:337–345. doi: 10.1016/j.juro.2014.05.005 CrossRefPubMedGoogle Scholar
  17. Lich R, Howerton LW, Davis LA (1962) Ureteral reflux, its significance and correction. South Med J 55:633–635CrossRefPubMedGoogle Scholar
  18. Liu HY, Dhillon HK, Yeung CK et al (1994) Clinical outcome and management of prenatally diagnosed primary megaureters. J Urol 152:614–617CrossRefPubMedGoogle Scholar
  19. Nelson CP, Chow JS (2008) Dextranomer/hyaluronic acid copolymer (Deflux) implants mimicking distal ureteral calculi on CT. Pediatr Radiol 38:104–106. doi: 10.1007/s00247-007-0613-z CrossRefPubMedGoogle Scholar
  20. Riccabona M (2010) Obstructive diseases of the urinary tract in children: lessons from the last 15 years. Pediatr Radiol 40:947–955. doi: 10.1007/s00247-010-1590-1 CrossRefPubMedPubMedCentralGoogle Scholar
  21. Riccabona M (2012) Application of a second-generation US contrast agent in infants and children – a European questionnaire-based survey. Pediatr Radiol 42:1471–1480. doi: 10.1007/s00247-012-2472-5 CrossRefPubMedPubMedCentralGoogle Scholar
  22. Riccabona M, Avni FE, Blickman JG et al (2009) Imaging recommendations in paediatric uroradiology. Minutes of the ESPR uroradiology task force session on childhood obstructive uropathy, high-grade fetal hydronephrosis, childhood haematuria, and urolithiasis in childhood. ESPR Annual Congress, Edinburgh, UK, June 2008. Pediatr Radiol 39:891–898. doi: 10.1007/s00247-009-1233-6 CrossRefPubMedPubMedCentralGoogle Scholar
  23. Riccabona M, Avni FE, Dacher J-N et al (2010) ESPR uroradiology task force and ESUR paediatric working group: imaging and procedural recommendations in paediatric uroradiology, part III. Minutes of the ESPR uroradiology task force minisymposium on intravenous urography, uro-CT and MR-urography in childhood. Pediatr Radiol 40:1315–1320. doi: 10.1007/s00247-010-1686-7 CrossRefPubMedPubMedCentralGoogle Scholar
  24. Riccabona M, Lobo ML, Papadopoulou F et al (2011) ESPR uroradiology task force and ESUR paediatric working group: imaging recommendations in paediatric uroradiology, part IV: minutes of the ESPR uroradiology task force mini-symposium on imaging in childhood renal hypertension and imaging of renal trauma in children. Pediatr Radiol 41:939–944. doi: 10.1007/s00247-011-2089-0 CrossRefPubMedPubMedCentralGoogle Scholar
  25. Schulman CC (1976) The single ectopic ureter. Eur Urol 2:64–69CrossRefPubMedGoogle Scholar
  26. Sirlin CB, Brown MA, Andrade-Barreto OA et al (2004) Blunt abdominal trauma: clinical value of negative screening US scans. Radiology 230:661–668. doi: 10.1148/radiol.2303021707 CrossRefPubMedGoogle Scholar
  27. Starr A (1979) Ureteral plication. A new concept in ureteral tailoring for megaureter. Invest Urol 17:153–158PubMedGoogle Scholar
  28. Sumfest JM, Burns MW, Mitchell ME (1995) Pseudoureterocele: potential for misdiagnosis of an ectopic ureter as a ureterocele. Br J Urol 75:401–405CrossRefPubMedGoogle Scholar
  29. Thomas DFM (2008) Prenatally diagnosed urinary tract abnormalities: long-term outcome. Semin Fetal Neonatal Med 13:189–195. doi: 10.1016/j.siny.2007.10.003 CrossRefPubMedGoogle Scholar
  30. Van Savage JG, Palanca LG, Andersen RD et al (2000) Treatment of distal ureteral stones in children: similarities to the american urological association guidelines in adults. J Urol 164:1089–1093CrossRefPubMedGoogle Scholar
  31. VanDervoort K, Wiesen J, Frank R et al (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 177:2300–2305. doi: 10.1016/j.juro.2007.02.002 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric UrologyUniversity Medical Center RegensburgRegensburgGermany

Personalised recommendations