Anesthesia for Pediatric Urological Procedures

摘要

Pediatric urological procedures are among the most common encountered by the pediatric anesthesiologist. This chapter reviews the embryological development of the common urogenital anomalies. It reviews the surgical approach, anesthetic considerations, and anesthetic management of these anomalies, including pain management. In addition, robotic approaches to urological surgery are explored. Anomalies of the genitourinary system that require surgical procedures under anesthesia often arise from abnormal development in utero. The genitourinary system is determined by both genetic and hormonal factors. Bladder exstrophy remains one of the most challenging conditions managed by pediatric urologists. The goals of reconstructive surgery for bladder exstrophy are to achieve closure of the bladder, obtain urinary continence, preserve renal function, and produce satisfactory appearance and function of the external genitalia. The most common cause of severe obstructive uropathy in children is posterior urethral valves. The urethral valves are tissue leaflets fanning distally from the prostatic urethra to the external urinary sphincter.