How I do it open distal ureteroureterostomy for ectopic ureters in infants with duplex systems and no vesicoureteral reflux under 6 months of age

ABSTRACT We describe a step by step technique for open distal ureteroureterostomy (UU) in infants less than 6 months presenting with duplex collecting system and upper pole ectopic ureter in the absence of vesicoureteral reflux (VUR).

Clinical features of neurogenic bladder with vesicoureteral reflux in children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of vesicoureteral reflux (VUR) in children with neurogenic bladder (NB), and to provide a reference for its early diagnosis and treatment.@*METHODS@#Clinical data were collected from 26 children with NB and urinary tract infection who were admitted to the Department of Pediatric Nephrology from January 2014 to December 2019. According to the presence or absence of VUR, the children were divided into a VUR group with 11 children and a non-VUR group with 15 children. Clinical features were compared between the two groups.@*RESULTS@#Compared with the non-VUR group, the VUR group had a significantly higher proportion of children with non-@*CONCLUSIONS@#When NB children have the clinical manifestations of non-

Vesicoureteral reflux in neonates with hydronephrosis; role of imaging tools

Neonatal Hydronephrosis is a common abnormality diagnosed ante- or postnatally. The aim of this study was to determine the prevalence and severity of vesicoureteral reflux [VUR] in neonates with antenatal or postnatal hydronephrosis and the value of ultrasonography as a noninvasive tool for VUR prediction. In a prospective study, 202 infants with neonatal hydronephrosis were studied. Two successive renal ultrasound examinations were performed at 1 and 4-6 weeks after birth in neonates with antenatal hydronephrosis or immediately after presentation. Voiding cystourethrography [VCUG] was performed in all infants. The incidence of VUR was 29.7%, of which 17.8% had severe [grade IV-V] reflux. 27% of 133 neonates with unilateral and 34.8% of 69 cases with bilateral hydronephrosis had VUR. Although a significant association was observed between severity of hydronephrosis and VUR, 5.9% of normal appearing and 7.8% of grade 1 hydronephrotic neonates had high-grade reflux. VUR was observed significantly in hydronephrotic neonates. A normal or mildly hydronephrotic urinary tract on ultrasound scan cannot exclude presence of severe VUR. We recommend performing VCUG in all hydronephrotic newborns

Vesico-ureteric reflux in children; diagnostic role of micturating cysto-urethrography

To evaluate the results of micturating cystourethrography [MCUG] in cases of vesicoureteric reflux [VUR] in children. A prospective study. The study included total number of 30 patients at CMH Multan and Panu Akil from 2001-2005. All the thirty patients less than twelve years of age, suspected of vesico-ureteric reflux, were subjected to MCUG examination to assess the lower urinary tract. Ultrasonography [USG] of urinary tract was also performed on all patients. The severity of reflux was graded before referral for further medical or surgical management. Majority of patients [63.33%] presented with recurrent urinary tract infection [UTI]. Renal scarring was detected in 86.66% on USG and all of them had grade IV and V reflux. Grading of reflux on MCUG revealed 33% grade 1 and II reflux and 66.7% as grade III to V reflux. A total of 76.66% patients had primary reflux with female preponderance. MCUG was found to be 100% sensitive in diagnosis of VUR when properly performed. Strong clinical suspicion of VUR in patients of UTI, must be subjected to MCUG for early diagnosis and appropriate management

Associated genitourinary tract anomalies in anorectal malformations: a thirteen year review.

Congenital anomalies in the genitourinary tract are the leading associated anomalies in infants with anorectal malformations (ARM). Certain anomalies such as vesicoureteric reflux (VUR) may cause permanent renal damage. OBJECTIVE: To review associated genitourinary tract anomalies in-cases of anorectal malformations and evaluate the efficacy of ultrasonography in detecting VUR. MATERIAL AND METHOD: Retrospective review of 183 patients with ARM undergoing anoplasty between 1988-2001. RESULTS: Genital anomalies were found in 14 per cent (26 cases). Urologic anomalies were detected in 25.6 per cent (47 cases), with a higher incidence in supralevator anomalies. The most common upper tract anomaly was hydronephrosis, which resolved spontaneously in most of them. VUR was found in 16 cases (21 refluxing units) or 20 per cent of patients to whom voiding cystourethrogram (VCUG) was done. Sonography detected hydroureter and/or hydronephrosis in 3 of 21 refluxing units, despite 17 of them being grade three or more. Half of the cases with reflux had urinary tract infection at least once in the follow-up period despite normal initial urinalysis. Parenchymal scar was positive in four cases with VUR. CONCLUSION: Thorough evaluation of the urinary tract is necessary in infants with anorectal malformations. Ultrasound is an accurate tool in the examination of the upper tract, but not sensitive enough to detect lower tract anomalies, especially VUR.

Evaluation of contrast ultrasonography in comparison with voiding cystourethrography in diagnosis of vesicoureteral reflux in young children

The aim of this study was to compare contrast ultrasonography with voiding cystourethrography in the diagnosis of vesicoureteral reflux in children. Thirty-one children were studied [21 girls and ten boys with age range 1-6 years]; 21 patients had bilateral reflux and ten patients had unilateral reflux with resultant 52 kidneys studied. The children were examined by conventional voiding cystourethrography. Ultrasonography using agitated saline as contrast material was done with monitoring the retrovesical ureters and the kidneys to detect refluxing material. Reflux was diagnosed by detecting the microbubbles in the ureters or the pelvicalyceal system. The results have indicated that voiding cystourethrography was used as gold standard for calculating the sensitivity and specificity of ultrasonography. Ultrasonography could not detect grade I reflux. It showed 84% sensitivity in the detection of grade II or greater reflux. Ultrasonography showed 100% sensitivity in the detection of grade III or greater reflux. The specificity of the procedure was 100%. It was concluded that contrast ultrasonography could be considered as a useful tool in the diagnosis and follow up of patients with vesicoureteral reflux except in grade I