Pediatric Urological Emergencies: Clinical-Etiological Profile and Management at the Conakry University Hospital

Abstract

Introduction: The objective of our study was to describe the clinical characteristics, highlight the etiologies and therapeutic modalities of pediatric urological emergencies. Material and Methods : Descriptive study with retrospective collection from 2019 to 2023 including all pediatric patients (≥17 years) who consulted urgently for a urological pathology. Results: We recorded 54 pediatric urological emergencies in five years, i.e. an average annual frequency of 10.8 cases. We found an increase in the annual frequency from 7 cases in 2019 to 17 cases in 2023. Adolescents and children were the most affected age groups, i.e. 50% and 46.29% respectively. The average age was 8.83 years. Urological emergencies mainly affected boys (89%) with a sex ratio of 8 boys to one girl. Bladder urinary retention, acute large scrotum, prolonged painful erections were the main reasons for emergency consultation, respectively 33.33%, 14.81% and 9.5%. On the etiological level, non-traumatic urological emergencies were dominated by posterior urethral valves (14.81%); spermatic cord torsion (11.11%), and ischemic priapism (9.25%). Traumatic emergencies were dominated by post-traumatic urethral strictures (11.11%) and recent urethral trauma (9.25%). Urethral catheterization (22.22%), suprapubic catheterization (20.37%), distal cavernospongious shunts (9.25%) were the most commonly performed emergency procedures. Conclusion: Pediatric urological emergencies are relatively rare in our practice, but their frequency is constantly increasing. They mainly affect boys and adolescents. Urinary retention in the bladder, acute large scrotal sac, ischemic priapism and urethral trauma are the main emergencies. Bladder drainage, spermatic cord detorsions, distal cavernous shunts are the main therapeutic modalities in emergencies.