Congenital Obstruction of the Urinary Tract

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About this Research Topic

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Background

Congenital obstructive uropathies are a heterogeneous group of developmental defects of the urinary tract characterized by an obstruction of the normal urinary flow, increasingly detected thanks to the widespread antenatal screening with ultrasound scans. It is well-known that most children with antenatally diagnosed urinary tract dilatations will have a spontaneous resolution. However, there is a significant number of cases that will worsen with the risk of a progressive and permanent loss of renal function. The main goal of pediatric urologists is the preservation of kidney function through an early selection of patients who will require surgical intervention as opposed to those who have chances to improve spontaneously.

Despite extensive clinical and experimental studies over the past decades, fundamental issues regarding the evaluation and management of children with urinary tract dilatations remain unsolved. Moreover, technological advancements and innovations have seen surgical techniques in endourology and minimally invasive surgery rapidly grow, extending their indications also in small babies. However, their advantages over conventional surgical techniques still need to be confirmed.

The scope of this Research Topic is to provide an overview of the most recent diagnostic and prognostic tools in the armamentarium of pediatric urologists to increase the understanding and elucidate the etiopathogenesis of renal injury and progression of renal disease in case of congenital obstructive uropathies (including lower urinary tract obstruction, obstructive megaureter, and ureteropelvic junction obstruction).

Studies discussing potential targets for diagnosis, prognosis, and treatment will be considered for publication together with the most promising biomarkers of renal injury and dysfunction.

Moreover, studies reporting the most recent innovations and cutting-edge techniques for the surgical treatment of obstructing uropathies will be evaluated with the ultimate aim to assess the applications of endourology and minimally invasive surgery (i.e. laparoscopic and robot-assisted surgery) in this field.

In summary, the scope of this Research Topic is therefore to describe the status of the clinical and surgical management of congenital obstructive uropathies, from diagnosis to follow-up, setting the basis for future developments in this field.

Keywords: congenital obstructive uropathy, ureteropelvic junction obstruction, obstructive megaureter, posterior urethral valves

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