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Screening for Obstructive Uropathy in Rural Egyptian Children 1784

Aim: The purpose of this study was to determine the prevalence and etiologies of obstructive uropathy in rural Egyptian children.Methods: Children residing in four villages representing four different geographical areas in the Sohag governorate were examined with portable sonographic equipment, using 3.5 and 5 MHz transducers, and also received complete physical examinations. Those diagnosed with obstructive uropathy were referred to Sohag University Hospital for further investigation.Results: 4,137 children (2,281 male and 1,856 female) aged 0-18 years were examined. Obstructive uropathy was detected in 69 children (1.7%). Twenty-nine children had mild pyelocaliectasis (anteroposterior renal pelvic diameter 10-15 mm). Twenty-one of these 29 children were infants less than 1 year of age, 28/29 had unilateral pyelocaliectasis, and 29/29 had no obstruction identified by intravenous pyelography and in addition had normal voiding cystourethrograms. Urinary tract stones were found in 14 children (11 unilateral). Other diagnoses included ureteral stricture (n = 5, 2 congenital, 3 with bilharziasis), ureteropelvic junction obstruction (4), meatal stenosis(4), urethral stricture (4), posterior urethral valves (3), neurogenic bladder(2), phimosis (2), ureterocele (1) and localized hydrocalicosis (1).Conclusions: Significant, treatable causes of obstructive uropathy were found in 0.9% (40/4,137) of rural Egyptian children. The high frequency of urinary tract stones is most likely attibutable to the hot, dry weather of upper Egypt, where Sohag is located. We believe that this prevalence of obstructive uropathy is sufficient to justify screening renal ultrasound in Egyptian children.