Doctors at Paras Bliss Hospital Panchkula successfully treated a 1 year old baby suffering from chronic kidney ailments, dribbling urine and pus from the private parts. The team of doctors guided and headed by Director of Paediatric Surgery – Dr KLN Rao – former HOD at PGI Chandigarh, performed the path breaking surgery to relieve the baby of the pain and a constrained life.
Baby Jagat, son of Mr and Mrs Saxena was diagnosed with swelling in the kidneys or hydronephrosis antenatally – when the baby was in the womb. After his birth through ultrasonography it was confirmed that the baby’s left kidney was divided into two parts and that there was also swelling on the side of the bladder. However at that age the baby did not show any signs of any complication or pain, hence it was deduced that the baby might heal naturally. However the parents were advised to get the child examined through regular follow ups.
According to Dr KLN Rao, Director Pediatric Surgery,” During a follow up visit it was reported that the baby was experiencing heavy urine infection, continuous leakage of urine and pus discharge from the private parts. Investigations also revealed that the left kidney was divided into two parts, with one half of kidney grossly dilated along with grossly dilated ureter, which is the pipe carrying urine from the kidney to the bladder. The other kidney was normal and the blood tests confirmed the same.”
He further states, “The nuclear medicine scan of the kidney showed that the baby had a normal right kidney. The upper part of the left kidney was dilated grossly and very poorly functioning. And the baby was continuously leaking urine from genitalia along with periodic normal passage of urine. Our diagnosis was that the baby was suffering from an ectopic ureter, which means the ureter instead of opening in urinary bladder was opening into the genitalia somewhere else and was constantly leaking urine.”
To treat ectopic ureter, pediatric surgeons have the following options – Cutaneous distal ureterostomy, Ureteral reimplantation, Partial nephrectomy or Ureteropyelostomy. In Baby Jagat’s case, since the moiety draining into the ectopic ureter was almost non functioning, a partial nephrectomy was recommended and performed.
Dr KLN Rao, leading pediatric surgeon of Tricity (Panchkula – Mohali – Chandigarh) shares, “Cutaneous distal ureterostomy may be necessary in a newborn with massive ureteral dilation and a functioning kidney. The ureter is surgically brought to the surface of the skin to allow it to drain urine freely into the diaper. This allows the affected kidney and ureter to decompress. Around 18 months of age, the ureter is then reimplanted into the correct position in the bladder. The baby was taken up for surgery, an X-ray study ruled out backflow of urine from the bladder. Then an Endoscopy was done into the urinary bladder. At surgery the upper half of left kidney which was grossly dilated and poorly functioning was removed. The baby recovered from the operation uneventfully and was discharged three days later. The final diagnosis was duplex kidney, upper half non functioning with ectopic ureteral opening.”