Semiología renal y genitourinaria en pediatría: primera parte / Nephrologoy and urology semiology in children: first part

A pesar de los avances tecnológicos, la historia clínica y el examen físico continúan y continuarán siendo la base de un buen enfoque y aproximación diagnóstica correcta, por ésto, la semiología sigue siendo un área muy importante en la medicina. En ésta revisión se plantea una guía sistemática e integral para la evaluación del sistema nefro-urológico en el niño desde las herramienta básicas y fundamentales como la historia clínica, el examen físico con sus componentessemiológicos en lo normal y lo patológico, integrando además los métodos diagnósticos de laboratorio e imagen disponibles en la actualidad, para lograr un buen enfoque y aproximación diagnóstica en niños con enfermedad renal.

Despite technological advances, medical history and physical examination remain the foundation of a good approach and correct diagnosis; semiology remains a very important area in medicine. In this review a systematic and comprehensive guide for the evaluation of nephron urological system in children is presented, with emphasis in medical history, physical examination and semiotic aspects, in normal and pathological conditions; additionally laboratory and imaging studies available to achieve a good diagnostic approach in children with renal disease are presented.

Relationship between site and size of bladder endometriotic nodules and severity of dysuria.

STUDY OBJECTIVE: The purpose of this study was to evaluate the relationship between frequency/severity of dysuria with anatomic location and diameter of bladder endometriotic lesions. DESIGN: Retrospective analysis (Canadian Task Force classification II-3). SETTING: Tertiary care university hospital. PATIENTS: Forty-one patients with bladder endometriosis (endometrial glands and stroma microscopically diagnosed to infiltrate the muscularis propria). INTERVENTIONS: Laparoscopic partial cystectomy, preoperative scoring of dysuria using 10-point verbal analog scale (VAS). MEASUREMENTS AND MAIN RESULTS: Records of all patients with bladder endometriosis were assessed for frequency/severity of preoperative dysuria, anatomic location (base or dome), and diameter of bladder endometriotic nodule. Basal bladder lesions were observed in 18 (43.9%) of 41 patients versus 23 (56.1%) of 41 in the dome. Of the patients with basal lesions, 14 (77.8%) of 18 had preoperative dysuria versus 8 (34.8%) of 23 with dome lesions. Mean VAS score was 8.5 +/- 2.37 and 5.75 +/- 1.91 for base and dome lesions, respectively. Preoperative dysuria was found in 22 (53.7%) of 41 patients. Mean lesion diameter in patients with dysuria was 25.0 +/- 12.6 mm versus 16.3 +/- 6.8 mm in patients without dysuria. CONCLUSION: Frequency and severity of preoperative dysuria were significantly higher in patients with basal endometriotic nodules. There was a positive correlation between severity of dysuria and lesion diameter.