Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis
Objective: To evaluate the utility of hydroureter (HU) to identify high-grade vesico-ureteric reflux (VUR) in patients with high-grade postnatal hydronephrosis (PH). Patients and methods: We retrospectively reviewed patients’ charts that had antenatal hydronephrosis from 2008 to 2014. Patients were...
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2018
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oai:doaj.org-article:ebbba41961eb482dabde81d8bd018cf72021-12-02T10:23:51ZInfluence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis2090-598X10.1016/j.aju.2017.11.004https://doaj.org/article/ebbba41961eb482dabde81d8bd018cf72018-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X17301389https://doaj.org/toc/2090-598XObjective: To evaluate the utility of hydroureter (HU) to identify high-grade vesico-ureteric reflux (VUR) in patients with high-grade postnatal hydronephrosis (PH). Patients and methods: We retrospectively reviewed patients’ charts that had antenatal hydronephrosis from 2008 to 2014. Patients were excluded if they presented with febrile urinary tract infection (fUTI), neurogenic bladder, posterior urethral valve, multi-cystic dysplastic kidney, and multiple congenital malformations. We reviewed postnatal ultrasonography images and patients with Society of Fetal Urology (SFU) Grades 3 and 4 hydronephrosis with a renal pelvic antero-posterior diameter of ≥10 mm were included. The ureter was assessed and considered dilated if the ureteric diameter was ≥4 mm. The voiding cystourethrogram (VCUG) studies, fUTI incidence, and surgical reports were reviewed. Results: Of the 654 patients reviewed, we included 148 patients (164 renal units) of whom 113 (76.4%) were male and 35 (23.6%) female. SFU Grade 3 PH was identified in 49% of the renal units, with the remaining 51% being SFU Grade 4. HU was found in 50/164 renal units and was not detected in the remaining 114 units. VUR was diagnosed in four units (3.5%) without HU (low-grade VUR); whilst it was detected in 19 units (38%) with HU (72.7% were high-grade VUR) (P < 0.001). VUR was diagnosed on the contralateral side in four/105 patients with PH without HU and diagnosed in 10/43 patients with PH with HU (P < 0.001). During a median follow-up of 25.9 months, none of the renal units that had VUR without HU developed UTI or had surgeries. Conclusion: Low-grade uncomplicated VUR was diagnosed in 3.5% of renal units without HU. Our results support limiting the use of VCUG to renal units with PH if associated with HU.Amr HodhodJohn-Paul CapolicchioRoman JednakEid El-SherifAbd El-Alim El-DorayMohamed El-SherbinyTaylor & Francis GrouparticleVoiding cystourethrographyCongenital hydronephrosisVesico-ureteric refluxPelvi-ureteric junction obstructionDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss 2, Pp 238-244 (2018) |
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DOAJ |
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| topic |
Voiding cystourethrography Congenital hydronephrosis Vesico-ureteric reflux Pelvi-ureteric junction obstruction Diseases of the genitourinary system. Urology RC870-923 |
| spellingShingle |
Voiding cystourethrography Congenital hydronephrosis Vesico-ureteric reflux Pelvi-ureteric junction obstruction Diseases of the genitourinary system. Urology RC870-923 Amr Hodhod John-Paul Capolicchio Roman Jednak Eid El-Sherif Abd El-Alim El-Doray Mohamed El-Sherbiny Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis |
| description |
Objective: To evaluate the utility of hydroureter (HU) to identify high-grade vesico-ureteric reflux (VUR) in patients with high-grade postnatal hydronephrosis (PH).
Patients and methods: We retrospectively reviewed patients’ charts that had antenatal hydronephrosis from 2008 to 2014. Patients were excluded if they presented with febrile urinary tract infection (fUTI), neurogenic bladder, posterior urethral valve, multi-cystic dysplastic kidney, and multiple congenital malformations. We reviewed postnatal ultrasonography images and patients with Society of Fetal Urology (SFU) Grades 3 and 4 hydronephrosis with a renal pelvic antero-posterior diameter of ≥10 mm were included. The ureter was assessed and considered dilated if the ureteric diameter was ≥4 mm. The voiding cystourethrogram (VCUG) studies, fUTI incidence, and surgical reports were reviewed.
Results: Of the 654 patients reviewed, we included 148 patients (164 renal units) of whom 113 (76.4%) were male and 35 (23.6%) female. SFU Grade 3 PH was identified in 49% of the renal units, with the remaining 51% being SFU Grade 4. HU was found in 50/164 renal units and was not detected in the remaining 114 units. VUR was diagnosed in four units (3.5%) without HU (low-grade VUR); whilst it was detected in 19 units (38%) with HU (72.7% were high-grade VUR) (P < 0.001). VUR was diagnosed on the contralateral side in four/105 patients with PH without HU and diagnosed in 10/43 patients with PH with HU (P < 0.001). During a median follow-up of 25.9 months, none of the renal units that had VUR without HU developed UTI or had surgeries.
Conclusion: Low-grade uncomplicated VUR was diagnosed in 3.5% of renal units without HU. Our results support limiting the use of VCUG to renal units with PH if associated with HU. |
| format |
article |
| author |
Amr Hodhod John-Paul Capolicchio Roman Jednak Eid El-Sherif Abd El-Alim El-Doray Mohamed El-Sherbiny |
| author_facet |
Amr Hodhod John-Paul Capolicchio Roman Jednak Eid El-Sherif Abd El-Alim El-Doray Mohamed El-Sherbiny |
| author_sort |
Amr Hodhod |
| title |
Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis |
| title_short |
Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis |
| title_full |
Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis |
| title_fullStr |
Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis |
| title_full_unstemmed |
Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis |
| title_sort |
influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis |
| publisher |
Taylor & Francis Group |
| publishDate |
2018 |
| url |
https://doaj.org/article/ebbba41961eb482dabde81d8bd018cf7 |
| work_keys_str_mv |
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