Neonatal hypertension from an obstructing ureterocele and vesicoureteral reflux in a solitary kidney

Neonatal hypertension is rare, such that there are no published protocol to follow on how to evaluate and address this problem. Most cases are incidental. This is a case of neonate who was found to be hypertensive on day one life. Screening and imaging studies were done to arrive at a particular etiology. Hypertension was related to an obstructing ureterocele and "vesicoureteral reflux in a solitary kidney" with a double collecting system. After surgical correction, the anti-hypertensive medications were tapered till the hypertension completely resolved. (Author)

Voiding patterns and bladder ultrasound features infants (1-24 months) with recurrent urinary tract infection and without urinary tract infection

OBJECTIVE: The purpose of this study is to determine and compare voiding patterns and ultrasound features among infants (1-24 months old) with recurrent urinary tract infection (UTI) among those without UTIMATERIALS AND METHODS: This is an analytical, cross sectional study on pediatric patients, aged 1-24 months )in March 1999 to March 2000, in a tertiary training hospital. The study included 100 infants. Group A are those with RUTI, (neurologically intact, other anomalies were ruled out by ultrasound and voiding cystourethrogram) and Group B are those without UTI, 50 subjects belong into each group. During 24 hour period, all micturitions were recorded in terms of voiding frequency, volume and character of voiding. The observation was completed with three repeated determination of residual urine volume and bladder index using ultrasound by single blinded sonologist who did not know the diagnosis of each case. Voiding patterns in terms of mean voiding frequency, mean volume per voiding and character of voiding were determined. Bladder ultrasound parameters include mean residual urine volume in milliliters and bladder index. Two groups were compared using T test with p value of 0.05RESULTS: The mean voiding frequency in Group A is 13.08 +/- 4.6 and 16.14 +/- 7.2 in Group B, p value of 0.01. The mean volume/ voiding is 33.88 +/- 15.2 in Group A and 40.12 +/- 37.4 in Group B with p value of 0.27. The mean bladder capacity is 44.02 +/- 29.5 in Group A and 66.48 +/- 29.4 in Group B with p value of 0.00. Twenty eight (28 percent) of those in Group A had interrupted voiding and none in Group B. The mean residual urine volume for Group A is 7.97 +/- 7.5 in Group A and 6.06 +/- 6.6 in Group B with P value of 0.183. Mean bladder index 0.06 +/- 0.03 for Group A and 0.07 +/- 0.03 with p value of 0.24CONCLUSION: The voiding patterns of infants with recurrent UTI is characterized by decreased frequency, volume and interrupted voiding. Determination of residual urine volume and bladder index in those with recurrent UTI and those with UTI proved that there was no difference. (Author)