Major urogenital malformations in Nigerian children

Abstract

Background: There is scanty data on the pattern of childhood urogenital malformations in many resource-poor countries, including Nigeria. Objective: To describe the pattern of occurrence of major urogenital malformations in children presenting in a tertiary health care centre in sub Saharan Africa. Design: Retrospective case review. Patients: All children with major urogenital malformations presented at the Department of Paediatrics of the University College Hospital, Ibadan, a large tertiary health care institution in South West Nigeria. In the period from July 1985 to December 1995. Main results: A total number of 125 cases of major urogenital malformations were seen during the study period. The commonest of these malformations were posterior urethral valves (40.0%), hypospedias(18.4%), ambiguous external genitalia (12.8%) andectopia vesicae (11.2%). Prenatal diagnosis was rare and most patients presented late. Mortality during first admission was14.4% (18/125), mostly accounted for by cases of posterior urethral valves. Conclusion: Posterior urethral valves accounted for the majority of major urogenital malformations seen in the setting studied. The high mortality probably reflected the severity of the lesions and late presentation of patients (which was related to the rarity of prenatal diagnosis). Increased awareness of these lesions among physicians practising in developing countries and greater use of ultrasonography in the third trimester of pregnancy may improve the prognosis by early detection and management.

Keywords

• epidemiology
• prenatal diagnosis
• urogenital system abnormalities