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Voiding cystourethrogram in the diagnosis of vesicoureteric reflux in children with antenatally diagnosed hydronephrosis.

Nerli RB, Amarkhed SS, Ravish IR - Ther Clin Risk Manag (2009)

Bottom Line: Children with fetal reflux may be diagnosed prior to urinary tract infection and in whom further renal injury may be prevented.VCUG when performed properly is safe and presents with little risk of infectious and noninfectious complications.Two patients had infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Kles Kidney Foundation, Nehru Nagar, Belgaum, India.

ABSTRACT

Unlabelled: Prenatal ultrasonography has revolutionized the detection and management of many urological abnormalities. Vesicoureteric reflux (VUR) which develops in 10% to 15% of cases of prenatal hydronephrosis, is difficult to predict prenatally. While all children with prenatal hydronephrosis should undergo ultrasonography within the first few weeks of life, there seems to be controversy regarding the role of voiding cystourethrogram (VCUG) in the assessment of these children.

Materials and methods: Neonates with antenatally diagnosed unilateral hydronephrosis were prospectively assessed with sonography on day 3-7, and VCUG and isotope imaging at three months.

Results: Seven (16.6%) children of the 42 children with Society of Fetal Urology grade 0/I/II hydronephrosis on postnatal sonography had evidence of VUR on VCUG. 44.4% of the refluxing ureters identified involved high grade disease and two (28.5%) children required reimplantation.

Conclusions: Children with fetal reflux may be diagnosed prior to urinary tract infection and in whom further renal injury may be prevented. VCUG when performed properly is safe and presents with little risk of infectious and noninfectious complications. VCUG should be done in children in whom hydronephrosis is detected prenatally to restrict the use of VCUG to diagnose VUR. Two patients had infection.

No MeSH data available.


Related in: MedlinePlus

A) postnatal ultrasound shows unilateral hydronephrosis. B) Voiding cystourethrogram shows Rt. grade III and Lt. grade V vesicoureteric reflux.
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f2-tcrm-5-0035: A) postnatal ultrasound shows unilateral hydronephrosis. B) Voiding cystourethrogram shows Rt. grade III and Lt. grade V vesicoureteric reflux.


Voiding cystourethrogram in the diagnosis of vesicoureteric reflux in children with antenatally diagnosed hydronephrosis.

Nerli RB, Amarkhed SS, Ravish IR - Ther Clin Risk Manag (2009)

A) postnatal ultrasound shows unilateral hydronephrosis. B) Voiding cystourethrogram shows Rt. grade III and Lt. grade V vesicoureteric reflux.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2697530&req=5

f2-tcrm-5-0035: A) postnatal ultrasound shows unilateral hydronephrosis. B) Voiding cystourethrogram shows Rt. grade III and Lt. grade V vesicoureteric reflux.
Bottom Line: Children with fetal reflux may be diagnosed prior to urinary tract infection and in whom further renal injury may be prevented.VCUG when performed properly is safe and presents with little risk of infectious and noninfectious complications.Two patients had infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Kles Kidney Foundation, Nehru Nagar, Belgaum, India.

ABSTRACT

Unlabelled: Prenatal ultrasonography has revolutionized the detection and management of many urological abnormalities. Vesicoureteric reflux (VUR) which develops in 10% to 15% of cases of prenatal hydronephrosis, is difficult to predict prenatally. While all children with prenatal hydronephrosis should undergo ultrasonography within the first few weeks of life, there seems to be controversy regarding the role of voiding cystourethrogram (VCUG) in the assessment of these children.

Materials and methods: Neonates with antenatally diagnosed unilateral hydronephrosis were prospectively assessed with sonography on day 3-7, and VCUG and isotope imaging at three months.

Results: Seven (16.6%) children of the 42 children with Society of Fetal Urology grade 0/I/II hydronephrosis on postnatal sonography had evidence of VUR on VCUG. 44.4% of the refluxing ureters identified involved high grade disease and two (28.5%) children required reimplantation.

Conclusions: Children with fetal reflux may be diagnosed prior to urinary tract infection and in whom further renal injury may be prevented. VCUG when performed properly is safe and presents with little risk of infectious and noninfectious complications. VCUG should be done in children in whom hydronephrosis is detected prenatally to restrict the use of VCUG to diagnose VUR. Two patients had infection.

No MeSH data available.


Related in: MedlinePlus