Posterior Urethral Valve : Its Clinical, Biochemical and Imaging Patterns

Size: px
Start display at page:

Download "Posterior Urethral Valve : Its Clinical, Biochemical and Imaging Patterns"

Transcription

1 Posterior Urethral Valve : Its Clinical, Biochemical and Imaging Patterns K BHAUMIK 1 I CHATTERJEE 2 KS BASU 3 N SAMANTA 4 S DAS 5 Purpose : To observe the clinical, biochemical and imaging patterns of Posterior Urethral Valve (PUV) patients and how they change after initial treatment and during follow-up. Methods : 79 patients of posterior urethral valves were studied between January, 2000 and June, Their age ranged from 1 day to 11 years. Presenting features of these patients were studied clinically. Biochemical studies as blood urea, serum creatinine, electrolytes and imaging studies as Micturating Cystourethrogram (MCU), Ultrasonography (USG) and renal isotope scan were performed. Result : 55% of the patients presented under one year of age. The most common presentation was poor urinary stream followed by dribbling of urine. 37% of the patients presented with palpable kidneys, 62% with recurrent Urinary tract infection (UTI). Blood urea and Serum creatinine were raised in 91% of patients. Electrolyte abnormalities were present in 22 cases. USG showed hydronephrosis in 87% of cases. Micturating Cystourethrogram (MCU) showed reflux in 45% of cases. Renal scan showed bilateral hydronephrosis, reduced Glomerular Filtration Rate (GFR) and delayed excretory pattern. Key Words : PUV, Urinary diversion, Vesicostomy. Posterior urethral valve is the commonest Dewan have identified it as a single structural cause of urinary outflow obstructing membrane with a small defect or obstruction in boys. 1 It is also the most opening in the posterior midline of the common type of obstructive uropathy urethra and prefers to call the entity leading to childhood renal failure. 2 Young congenital obstructing posterior urethral classified the morphological variation of the membrane (COPUM). 3 Though there is valvular obstruction into 3 types. Recently controversy regarding the development and Department of Pediatric Surgery NRS Medical College & Hospital Kolkata, India 1 & 2 MCh (Post Doctoral Trainee) 3 RMO cum Clinical Tutor 4&5 Professors Dr K Bhaumik 22, Iswar Gupta Road Kolkata Phone-(033) kuntalbhaumik@vsnl.net

2 154 J INDIAN ASSOC PEDIATR SURG VOL 8 (JUL-SEP 2003) nature of the valve (3, 4), the entire urinary tract from the level of obstruction upwards is affected by the lesion to a varying degree. 5 The incidence of PUV ranges from 1 in to 1 in live male births and it constitutes about 10% of prenatally diagnosed hydronephrosis. 7 Patients with the most severe form of the disease often die immediately after birth and do not present for treatment. 8 In addition, up to 26% of patients treated in the neonatal period subsequently develop end stage renal failure. 9 There is an intermediate group that does not require renal transplantation but also does not have enough renal function to permit growth and development. 10 Materials and Methods In a period of two & half years from Jan 2000 to June 2002, 79 patients, age ranging from 1 day to 11 years, were admitted in our department with PUV. We have studied the clinical, biochemical and imaging patterns of all these patients at presentation and after initial treatment. At presentation, all the urinary and non-urinary symptoms were noted (Table I & II). Blood was collected for estimation of blood urea, serum creatinine, complete hemogram and electrolytes, at presentation and also after initial treatment. USG of abdomen were done at presentation and also during follow up. Renal scan was performed initially, usually after one month of initial treatment and then during follow up period to ascertain any improvement or deterioration in function. Results In our study, 21 out of 79 patients (27%) presented within one month, 22 patients (28%) between the age of one month and one year. 29 patients (36%) were in the age group of 1 to 6 years and 7 (9%) were between 6 and 11 years of age (Fig. 1). Antenatal USG was performed in 14 cases. In 3 cases, PUV was suspected antenatally due to presence of bilateral hydronephrosis, thick walled distended bladder and less amniotic fluid.

3 PUV : CLINICAL, BIOCHEMICAL & IMAGING PATTERNS 155 At presentation, blood urea & serum creatinine were raised in 72 patients (91%). Creatinine level was above 1.5 mg% in 42 patients (53%) and between 1 & 1.5 mg% in 30 patients (38%). Hemoglobin level was 90% & below in 27 cases (34.2%). Hyponatremia and hyperkalemia were noted in 22 cases. On examination of urine, plenty of pus cells & positive urine culture were noted in 51 patients (65.5%). Most common organism grown was E. Coli. USG revealed dilated posterior urethra & distended thick walled bladder in all cases. Hydronephrosis was seen in 69 cases (87.3%) and hydroureter in 46 cases (58.2%). Corticomedullary junction could be identified in 30 cases. Of the 49 patients who had non-visualisation of Corticomedullary junction, 42 had impaired renal function. MCU was performed in all cases and all of them showed dilated and elongated posterior

4 156 J INDIAN ASSOC PEDIATR SURG VOL 8 (JUL-SEP 2003) urethra. Margin of the bladder was irregular and multiple pseudo-diverticulae were noted in 49 patients. Vesicoureteric reflux was seen in 36 cases (46%) at presentation of which bilateral reflux was present in 19 (24%). Among the 17 cases of unilateral reflux, right side was affected in 7 cases and left side in 10 cases. Nine cases showed severe reflux (Gr. IV & V). DTPA renal scan was performed in 63 cases, all of which showed bilateral hydronephrosis of mild to moderate degree. Perfususion was low and there was grossly delayed excretory pattern. GFR was reduced in the affected kidneys. As a routine first scan was performed one month after initial treatment. At presentation, 62 patients were treated by bladder catheterisation and intravenous antibiotics. After proper resuscitation with intravenous fluid, correction of electrolyte imbalance and acidosis either vesicostomy or valve fulguration was done. As we do not have a small sized cystoscope or resectoscope in our institute, we could not perform primary valve fulguration in infants below one year of age. Thus in all the patients who were very sick at presentation, and all the patients below one year of age, we performed vesicostomy (in 51 cases). Primary valve fulguration was done in 27 cases. In 8 cases, after primary valve fulguration, the patient's condition did not improve and the blood urea and serum creatinine level did not come down. Vesicostomy was performed as a secondary procedure. In 4 cases the urinary drainage after primary vesicostomy was not adequate and the biochemical parameters did not improve. High diversion in the form of bilateral ureterostomies were performed in these patients. Complications of vesicostomy were wound infection, stomal stenosis, and mild prolapse. In 4 cases vesicostomy was revised to treat stenosis. In our series, 4 patients expired. One patient who presented with severe respiratory distress, edema and renal failure died on first day. One patient died due to severe urosepsis on the fourth day after the vesicostomy; 2 patients died of renal failure even after performing bilateral ureterostomies, one at 5 months of age and another at 7 months of age. Two patients presented with acute renal failure and were treated with peritoneal dialysis one of them expired. After vesicostomy, valve fulguration was performed in 24 cases when the infants were older and had gained in weight. So far in this series, vesicostomy closure was performed in 7 cases. In the follow-up, at one month, serum creatinine level came down in 43 out of 72 patients. Creatinine level was improved in 31 cases out of 51 vesicostomies & in 12 cases out of 21 cases of primary valve fulguration. Creatinine level at presentation was below 1 mg% in 7 patients, between 1 & 1.5 mg% in 30 patients, between 1.5 & 3 mg% in 25 patients and above 3 mg% in 17 patients. At one year follow-up, out of 71 patients only 18 patients had serum creatinine level above 1, in rest of the patients it was below 1 mg%. At 2 years follow-up, 7 patients were lost to follow-up. Out of 68 patients seen at two years, 7 patients had creatinine level above 1 mg%. Follow-up MCU in 3 cases who had Grade I & II reflux showed resolution within 2 years, and the grade of reflux improved in 11 other cases. Subsequent renal scan in 9 cases

5 PUV : CLINICAL, BIOCHEMICAL & IMAGING PATTERNS 157 showed improvement of excretory pattern. Discussion Approximately one third of PUV patients present during the neonatal period, onethird between 1 month and 1 year and one third over one year of age. 9,11,12 More recent reviews have demonstrated increased presentation during the neonatal period and this early presentation is atributed to greater awareness about the condition, and better antenatal diagnosis. 1 PUV is increasingly recognised by routine prenatal USG. 1,13, 14 The characteristic findings are bilateral hydronephrosis and a distended thickened bladder. A dilated posterior urethra is seen occasionally. Low amniotic fluid and bright renal parenchyma (suggestive of dysplasia) provide important clues about the severity of renal damage. In our series, antenatal USG was performed in 14 patients. In 3 of these patients, PUV was suspected because of bilateral hydronephrosis. Out of these 3 patients, one patient was very sick at birth and died on the first day before any surgical intervention could be done. Whether prenatal diagnosis has any impact on long term outcome of these patients is still controversial. 9 In neonates, obstructive symptoms (straining, poor stream, dribbling, palpable bladder) may be seen in 77% of cases and many of them present with features of renal failure. 1,11 Infants present with features of infection (78%) like septicemic shock, poor feeding, abdominal pain, and positive urine culture. 11 They also present with abdominal distention, dribbling of urine (40%), failure to thrive (30%) and palpable kidneys (25%). 13 In toddlers, renal failure becomes less common but voiding symptoms and infection predominate, 50% of patients over 5 years of age present with enuresis and dribbling. 1 These later presentations is indicative of milder forms of valvular obstruction and their presentation may be delayed into adulthood. 5 In our series, obstructive symptoms in the form of poor stream and dribbling were present in all patients. In 11 patients who were of older age group the symptoms were present for a short period, 37% of patients presented with a palpable kidney and 62% presented with recurrent UTI. Renal failure was more common in those who presented at an earlier age. Failure to thrive was observed in 43% of patients. At presentation, 91% patients had raised blood urea & serum creatinine levels and at one month follow-up, the scrum creatinine level remained high in 72% of cases. At one year follow-up, 23% of patients and at 2 years follow-up, 10% of patients had serum creatinine level above 1 mg%. In contrast to an incidence of 40% in published literature. 25% of neonates in our series presented with urinary ascites. 15 USG demonstrates hydrouretcrone-phrosis, thick walled bladder, dilated posterior urethra and occasionaly bright kidneys with loss of cortico-medullary differentiation suggestive of renal dysplasia. 16 In our series cortico-medullary junction was well demarcated in 38% of cases while the demarcation was lost in 49 patients (62%). MCU is the gold standard in diagnosis of a case of posterior urethral valve. It permits assessment of vesico-ureteric reflux in almost 50% patients. 17 Of these, 20% will

6 158 J INDIAN ASSOC PEDIATR SURG VOL 8 (JUL-SEP 2003) have renal dysplasia. 9,18 In 15%, there is spontaneous resolution of reflux and in the remaining 15% reflux persists and needs surgical correction. 18 In our series, 36 patients (46%) presented with reflux and during a short follow-up, 3 patients showed resolution of reflux. Since the introduction of neonatal resectoscope, management of PUV cases have changed but a group of patients still require diversion. High rate of diversion in our series is due to non-availability of a neonatal resectoscope. We have found that vesiscostomy is a very useful method of diversion, as functioning vesicostomy provides an adequate drainage of the lower urinary tract as proposed by Duckett. 19,20 It is a minimally invasive surgery and is an easily reversible technique. It allows cycling of the bladder to take place at a low pressures. 21 We performed secondary vesicostomy in 8 patients and we believe that it is an excellent choice to treat otherwise refractory urinary sepsis and to stabilise renal function. Bilateral ureterostomy was advocated by some authors as a better alternative method of diversion in developing countries, for patients with persistently high serum creatinine level. 22 However in our series ureterostomies had to be done only in 4 cases as a secondary procedure after vesicostomy had failed to drain the upper urinary tract adequately. This is an ongoing study. Clinical parameters and investigation parameters of 79 patients over a period of two and half years are being presented for a disease like PUV which has varied manifestations. Long-term follow up is necessary to see the effect of treatment in these patients. Aggressive management of vesicoureteric reflux with early surgical intervention is rarely justified as upper urinary tract complications resolve spontaneously in some cases. In our short follow up we have observed resolution of reflux in 3 cases. References 1 Atwell JD posterior urethral valves in the British Isles a multicenter BAPS review. J Pediatr Surg. 1983; 18: Warshaw BL, Edelbrock HH, Ettenger RB, et al. Renal transplantation in children with obstructive uropathy. J Urol 1980; 123: Dewan PA, GoH DG Variable expression of the congenital obstructive posterior urethral membrane. Urol 1995; 45: Dewan PA (Guest Ed) Congenital obstruction in the Male Urethra Dialogues. Pediatr Urol 1995; 18: Hendren WH Posterior urethral valve in boys. A broad clinical spectrum. J Urol 1971;106: Casale AJ. Early Urethral surgery for posterior urethral valves. Urol Clin North Am. 1990; 17: Brown T, Mandell J, Lebowitz RL. Neonatal hydronephrosis in the era of sonography. Am J Roentgenol. 1987; 148: Nakayama DK, Harrison MR, delorimier AA. Prognosis of posterior urethral valves presenting at birth. J Pediatr Surg. 1986; 21: Parkhouse HF, Barratt TM, Dillon MJ, et al. Long-term outcome of boys with posterior urethral valves, Br J Urol. 1988; 62:59-62.

7 PUV : CLINICAL, BIOCHEMICAL & IMAGING PATTERNS Churchill BM, Mclorie GA, Khoury AE et al. Emergency treatment and long-term follow-up posterior urethral valves. Urol Clin North Amer 1990; 17 : Scott JE. Management of congenital posterior urethral valves. Br J Urol 1985; 57: Johnston JH, Kulatilake AE. The sequelae of posterior urethral valves. Br J Urol 1971; 43: Churchill BM, Fleisher MH, Krueger R, et al. Posterior Urethral valve management. Dialog Pediat Urol 1983; 6: Dinnen MD, Dhilon HK, Ward HC, et al. Antenatal diagnosis of posterior urethral valves Br J Urol 1993; 72: Parker RM. Neonatal urinary ascities. A potentially favourable sign in bladder outlet obstruction. Urology 1974; 3: Cremin BJ, Aaronson IA. Ultrasonic diagnosis of posterior urethral valve in neonates. Br J Radiol 1983; 56: Duckett JW. Management of posterior urethral valves. AUA Update series. 1983; 2: Hoover DL. Duckett J Jr. Posterior urethral valves, unilateral reflux and renal dysplasia; a sysndrome. J Urol 1982; 128: Duckett J Jr. Current management of Posterior Urethral valves. Urol clin North Am 1974; 1: Duckett JW. Cutaneous vesicostomy in infants and children. Urol Clin North Am 1974; 1: Khoury AE, Houle AM. Mclorie GA et al. Cutaneous vesicostomy effect on bladder's eventual function. Dial Pediatr 1990; 13:2. 22 Parag P, Sen S, Chacko J, et al. Bilateral high loop ureterostomy in the primary management of Posterior urethral valves in a developing country. Pediatr Surg Int 2001; 17:

Clinical Spectrum of Posterior Urethral Valve Obstruction in Children

Clinical Spectrum of Posterior Urethral Valve Obstruction in Children Clinical Spectrum of Posterior Urethral Valve Obstruction in Children S ROY CHOUDHURY 1 R CHADHA 2, A PURI 3, A PRASAD 4, A SHARMA 5 A KUMAR 6 Children with posterior Urethral valve (PUV) obstruction constitute

More information

Case MDCT 3D reconstructed features of posterior urethral valve

Case MDCT 3D reconstructed features of posterior urethral valve Case 12688 MDCT 3D reconstructed features of posterior urethral valve Hidayatullah Hamidi Third year Resident of Radiology French medical institute for children Radiology Department; Kabul, Afghanistan;

More information

Urinary Ascites in Newborn A Rare Case Report

Urinary Ascites in Newborn A Rare Case Report ISSN 2231-4261 CASE REPORT Urinary Ascites in Newborn A Rare Case Report Suryakant Y. Ingale 1*, Sudhakar Jadhav 2, Kant Shah 2 1 Department of Paediatrics, Krishna Institute of Medical Sciences, Karad

More information

A STUDY ON LONGTERM OUTCOMES OF POSTERIOR URETHRAL VALVES

A STUDY ON LONGTERM OUTCOMES OF POSTERIOR URETHRAL VALVES 3 Original article A STUDY ON LONGTERM OUTCOMES OF POSTERIOR URETHRAL VALVES Dr. Urvish R. Parikh [1], Dr Sudhir B. Chandana [], Dr Vinay M. Rohra [3],, Dr Jay B. Pandya [5], Dr Ankit B. Kothari [4] Assistant

More information

Posterior urethral valves (PUV) account for endstage

Posterior urethral valves (PUV) account for endstage Pediatric Urology Delayed Presentation in Posterior Urethral Valve: Long-Term Implications and Outcome M. S. Ansari, Pratipal Singh, Anil Mandhani, Deepak Dubey, Aneesh Srivastava, Rakesh Kapoor, and Anant

More information

Anterior Urethral Valves

Anterior Urethral Valves Case Report Anterior Urethral Valves Vidyadhar P. Mali, K. Prabhakaran and Dale S.K.L. Loh, Department of Paediatric Surgery, National University Hospital, Singapore. We studied the clinical presentation

More information

Lower Urinary Tract Obstruction LUTO or Bladder Outlet Obstruction BOO. Miss Harriet Corbett Consultant Paediatric Urologist

Lower Urinary Tract Obstruction LUTO or Bladder Outlet Obstruction BOO. Miss Harriet Corbett Consultant Paediatric Urologist Lower Urinary Tract Obstruction LUTO or Bladder Outlet Obstruction BOO Miss Harriet Corbett Consultant Paediatric Urologist Aims To give an overview of the anomalies we encounter presentation of LUTO how

More information

Posterior Urethral Valve : The Current Perspective

Posterior Urethral Valve : The Current Perspective Posterior Urethral Valve : The Current Perspective PG DUFFY, SK CHOWDHARY The posterior urethral valve is the commonest cause of bladder outlet obstruction in children. With the improvement of primary

More information

Diversion in Posterior Urethral Valves: Needs and Results

Diversion in Posterior Urethral Valves: Needs and Results Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/154 Diversion in Posterior Urethral Valves: Needs and Results Ramdhani Yadav 1, Sandip Kumar Rahul 1, Vinit Kumar Thakur

More information

Role of Imaging Modalities in the Management of Urinary Tract Infection in Children

Role of Imaging Modalities in the Management of Urinary Tract Infection in Children Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/182 Role of Imaging Modalities in the Management of Urinary Tract Infection in Children M S Vinodkumar 1, M Vishnu

More information

Hydronephrosis. Nephrosis. Refers to the kidney

Hydronephrosis. Nephrosis. Refers to the kidney What is hydronephrosis? Hydro Nephrosis Refers to water or fluid Refers to the kidney A build-up of fluid (urine) in the kidney is the medical term for a build-up of urine in the kidney. As the urine builds

More information

Laparoscopic Diverticulocystoplasty for Low Compliance Bladder in a Child

Laparoscopic Diverticulocystoplasty for Low Compliance Bladder in a Child CASE REPORT Laparoscopic Diverticulocystoplasty for Low Compliance Bladder in a Child Manickam Ramalingam, MCh, Kallappan Senthil, MCh, Anandan Murugesan, MCh, Mizar Ganapathy Pai, MCh ABSTRACT Low compliance

More information

Hydronephrosis. What is hydronephrosis?

Hydronephrosis. What is hydronephrosis? What is hydronephrosis? Hydronephrosis Hydronephrosis describes the situation where the urine collecting system of the kidney is dilated. This may be a normal variant or it may be due to an underlying

More information

Indications and effectiveness of the open surgery in vesicoureteral reflux

Indications and effectiveness of the open surgery in vesicoureteral reflux Indications and effectiveness of the open surgery in vesicoureteral reflux Suzi DEMIRBAG, MD Department of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, TURKEY Vesicoureteral reflux (VUR)

More information

CONGENITAL ANTERIOR URETHRAL DIVERTICULUM

CONGENITAL ANTERIOR URETHRAL DIVERTICULUM CONGENITAL ANTERIOR URETHRAL DIVERTICULUM W Y Cheong, H K Cheng, K P Tan SYNOPSIS We report the first documented case in Singapore of a congenital saccular anterior urethral diverticulum causing bladder

More information

Developmental Abnormalities of the Kidneys and GU System

Developmental Abnormalities of the Kidneys and GU System A5 Developmental Abnormalities of the Kidneys and GU System Erin Parilla, MD Neonatologist Pediatrix Medical Group, Tampa, FL The speaker has signed a disclosure form and indicated she has no significant

More information

Prenatal Hydronephrosis

Prenatal Hydronephrosis Prenatal Hydronephrosis What is hydronephrosis? Hydronephrosis is dilation of the kidney, specifically the renal pelvis (place where urine is stored after its production). This can be the result of an

More information

Ascites, a New Cause for Bilateral Hydronephrosis: Case Report

Ascites, a New Cause for Bilateral Hydronephrosis: Case Report Case Study TheScientificWorldJOURNAL (2009) 9, 1035 1039 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2009.112 Ascites, a New Cause for Bilateral Hydronephrosis: Case Report D. Jain*, S. Dorairajan, and

More information

Chapter 6: Genitourinary and Gastrointestinal Systems 93

Chapter 6: Genitourinary and Gastrointestinal Systems 93 Chapter 6: Genitourinary and Gastrointestinal Systems 93 Chapter 6 Genitourinary and Gastrointestinal Systems Embryology Three sets of excretory organs or kidneys develop in human embryos: Pronephros:

More information

Vesicoureteral Reflux (VUR) New

Vesicoureteral Reflux (VUR) New Vesicoureteral Reflux (VUR) New What is vesicoureteral reflux? Vesicoureteral reflux is the abnormal backflow of urine from the bladder into the ureter and up to the kidney. The majority of the time this

More information

Zemestan 1367 Medical Journal of the. Jamadiolawwal ,,1;lfnit Rt'ruhlic of Iran. Original Articles

Zemestan 1367 Medical Journal of the. Jamadiolawwal ,,1;lfnit Rt'ruhlic of Iran. Original Articles Volume 2 Number 4 Zemestan 1367 Medical Journal of the Jamadiolawwal 140 1,,1;lfnit Rt'ruhlic of Iran ] Original Articles A NEW APPROACH TO VESICOURETERAL REFLUX PERSISTING AFTER POSTERIOR URETHRAL VALVE

More information

Hollow Visceral Myopathy in a 5-year old Boy: a Case Report

Hollow Visceral Myopathy in a 5-year old Boy: a Case Report Hollow Visceral Myopathy in a 5-year old Boy: a Case Report S.H.T. Zaidi,Z. Zaidi ( The Kidney Centre Postgraduate Training Institute. Karachi. ) M. Arif ( Department of Paediatric Urology and Histopathology,

More information

Recurrent Pediatric UTI Revisited 2013

Recurrent Pediatric UTI Revisited 2013 Recurrent Pediatric UTI Revisited 2013 PIDSP 21.2.2013 Shai Ashkenazi, MD, MSc Medicine changes constantly Some aspects of the standard practice of ~40 years are probably not valid and need to be changed

More information

UWE Bristol. UTI in Children. Angie Green Visiting Lecturer March 2011

UWE Bristol. UTI in Children. Angie Green Visiting Lecturer March 2011 UWE Bristol UTI in Children Angie Green Visiting Lecturer March 2011 Approx 2% children will develop acute febrile UTI Up to 10% girls will develop any kind of UTI Progressive scarring in children with

More information

Setting the Speed Limit: A Pilot Study of the Rate of Serum Creatinine Decrease After Endoscopic Valve Ablation in Neonates

Setting the Speed Limit: A Pilot Study of the Rate of Serum Creatinine Decrease After Endoscopic Valve Ablation in Neonates Setting the Speed Limit: A Pilot Study of the Rate of Serum Creatinine Decrease After Endoscopic Valve Ablation in Neonates A. V. Deshpande, B. S. Alsaywid and G. H. H. Smith* From the Department of Urology

More information

Urinary Tract Abnormalities

Urinary Tract Abnormalities Urinary Tract Abnormalities Dr Hennie Lombaard Senior Specialist Maternal and Fetal Medcine Department of Obstetrics and Gynecology Level 7 Pretoria Academic Hospital Pictures from The 18 to 23 weeks scan

More information

THE DYSFUNCTIONAL 'LAZY' BLADDER SYNDROME IN CHILDREN*

THE DYSFUNCTIONAL 'LAZY' BLADDER SYNDROME IN CHILDREN* THE DYSFUNCTIONAL 'LAZY' BLADDER SYNDROME IN CHILDREN* BY FRANK G. DELUCA, ORVAR SWENSONt, JOHN H. FISHER and ADEL H. LOUTFI From the Boston Floating Hospital for Infants and Children, Boston, Massachusetts

More information

Spectrum of Micturating Cystourethrogram Revisited: A Pictorial Assay

Spectrum of Micturating Cystourethrogram Revisited: A Pictorial Assay 603 International Journal of Collaborative Research on Internal Medicine & Public Health Spectrum of Micturating Cystourethrogram Revisited: A Pictorial Assay Abhinav Jain 1, Vivek Setia 1, Shweta Agnihotri

More information

Posterior Urethral Valves

Posterior Urethral Valves Review Special Issue: Pre- and Postnatal Management of Hydronephrosis TheScientificWorldJOURNAL (2009) 9, 1119 1126 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2009.127 Posterior Urethral Valves Steve

More information

Posterior Urethral Valve Treatments and Outcomes in Children Receiving Kidney Transplants

Posterior Urethral Valve Treatments and Outcomes in Children Receiving Kidney Transplants Posterior Urethral Valve Treatments and Outcomes in Children Receiving Kidney Transplants Matthew S. Fine,* Kenneth M. Smith, Dhirendra Shrivastava, Marie E. Cook and Aseem R. Shukla From the Division

More information

Urinary ascites from spontaneous bladder perforation in female neonate

Urinary ascites from spontaneous bladder perforation in female neonate Ped Urol Case Rep 2015;2(6):27-32 DOI:10.14534/PUCR.2015614087 Ped Urol Case Rep PEDIATRIC UROLOGY CASE REPORTS ISSN: 2148 2969 Journal homepage: http://www.pediatricurologycasereports.com Urinary ascites

More information

Pediatric urinary tract infection. Dr. Nariman Fahmi Pediatrics/2013

Pediatric urinary tract infection. Dr. Nariman Fahmi Pediatrics/2013 Pediatric urinary tract infection Dr. Nariman Fahmi Pediatrics/2013 objectives EPIDEMIOLOGY CAUSATIVE PATHOGENS PATHOGENESIS CATEGORIES OF URINARY TRACT INFECTIONS AND CLINICAL MANIFESTATIONS IN pediatrics

More information

Pediatric GU Dysfunction

Pediatric GU Dysfunction Pediatric GU Dysfunction Assessment of pediatric renal function Signs and symptoms Laboratory tests Radiological tests Nursing considerations Psychosocial and developmental considerations GU Disorders

More information

Controversies around antenatally detected PUJ syndrom. Amy Piepsz, CHU St Pierre, Brussels, Belgium

Controversies around antenatally detected PUJ syndrom. Amy Piepsz, CHU St Pierre, Brussels, Belgium Controversies around antenatally detected PUJ syndrom Amy Piepsz, CHU St Pierre, Brussels, Belgium Editors : Anthony Caldamone, USA Pierre Mouriquand, France Newborn boy History of prenatally diagnosed

More information

Renal survival analysis of CAKUT and outcomes in chronic kidney disease.

Renal survival analysis of CAKUT and outcomes in chronic kidney disease. Curr Pediatr Res 2017; 21 (4): 691-695 ISSN 0971-9032 www.currentpediatrics.com Renal survival analysis of CAKUT and outcomes in chronic kidney disease. Oke Rina Ramayani 1, Kiking Ritarwan 2, Putri Chairani

More information

Bilateral Orthotopic Ureteroceles

Bilateral Orthotopic Ureteroceles JOURNAL OF CASE REPORTS 2016;6(3):435-440 Bilateral Orthotopic Ureteroceles Mohammed R. Aljumaili 1, Samy M. Arafat 1, Mustafa Y. Rashid Al-badra 2, Safaa K. Mohammed 2 Department of 1 Urology and 2 Radiology,

More information

Pattern of Renal Function Deterioration as a Predictive Factor of Unilateral Ureteropelvic Junction Obstruction Treatment

Pattern of Renal Function Deterioration as a Predictive Factor of Unilateral Ureteropelvic Junction Obstruction Treatment european urology 51 (2007) 551 555 available at www.sciencedirect.com journal homepage: www.europeanurology.com Pediatric Urology Pattern of Renal Function Deterioration as a Predictive Factor of Unilateral

More information

UTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys.

UTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys. UTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys. 1-3% of Below 1 yr. male: female ratio is 4:1 especially among uncircumcised males,

More information

16.1 Risk of UTI recurrence in children

16.1 Risk of UTI recurrence in children 16. UTI prognosis 16.1 Risk of UTI recurrence in children Key question: What is the risk of recurrent UTI in children with no known structural or functional abnormalities of the urinary tract with a first

More information

Prevalence of recurrent urinary tract infection in children with congenital anomalies of the kidney and urinary tract (CAKUT)

Prevalence of recurrent urinary tract infection in children with congenital anomalies of the kidney and urinary tract (CAKUT) IOP Conference Series: Earth and Environmental Science PAPER OPEN ACCESS Prevalence of recurrent urinary tract infection in children with congenital anomalies of the kidney and urinary tract (CAKUT) To

More information

Is antibiotic prophylaxis of any use in nephro-urology? Giovanni Montini Pediatric Nephrology and Dialysis Unit University of Milan Italy

Is antibiotic prophylaxis of any use in nephro-urology? Giovanni Montini Pediatric Nephrology and Dialysis Unit University of Milan Italy Is antibiotic prophylaxis of any use in nephro-urology? Giovanni Montini Pediatric Nephrology and Dialysis Unit University of Milan Italy UTI_VUR Bacteria and Humans: diverse behaviours!! Bacteria Humans

More information

Find Medical Solutions to Your Problems HYDRONEPHROSIS. (Distension of Renal Calyces & Pelvis)

Find Medical Solutions to Your Problems HYDRONEPHROSIS. (Distension of Renal Calyces & Pelvis) HYDRONEPHROSIS (Distension of Renal Calyces & Pelvis) Hydronephrosis is the distension of the renal calyces and pelvis due to accumulation of the urine as a result of the obstruction to the outflow of

More information

Audit of Micturating Cystourethrograms performed over 1 year in a Children's Hospital

Audit of Micturating Cystourethrograms performed over 1 year in a Children's Hospital Audit of Micturating Cystourethrograms performed over 1 year in a Children's Hospital Poster No.: C-1773 Congress: ECR 2012 Type: Scientific Exhibit Authors: K. Lyons, J. Sorensen, E. L. Twomey, V. Donoghue,

More information

Case Based Urology Learning Program

Case Based Urology Learning Program Case Based Urology Learning Program Resident s Corner: UROLOGY Case Number 23 CBULP 2011 077 Case Based Urology Learning Program Editor: Associate Editors: Manager: Case Contributors: Steven C. Campbell,

More information

Nursing Care for Children with Genitourinary Dysfunction I

Nursing Care for Children with Genitourinary Dysfunction I Nursing Care for Children with Genitourinary Dysfunction I 1 Assessment of renal function Clinical manifestations Laboratory tests Urinalysis Urine culture and sensitivity Renal/bladder ultrasound Testicular

More information

IMAGING PROFILE OF CHILDREN BIRTH TO 12 YEARS PRESENTING WITH FIRST URINARY TRACT INFECTION (UTI) AT A TERTIARY CARE HOSPITAL

IMAGING PROFILE OF CHILDREN BIRTH TO 12 YEARS PRESENTING WITH FIRST URINARY TRACT INFECTION (UTI) AT A TERTIARY CARE HOSPITAL IMAGING PROFILE OF CHILDREN BIRTH TO 12 YEARS PRESENTING WITH FIRST URINARY TRACT INFECTION (UTI) AT A TERTIARY CARE HOSPITAL Yengkhom Rameshwor Singh 1, Okram Pusparani Devi 2, Tonjam Hemchand Singh 3

More information

GU Ultrasound in First Trimester

GU Ultrasound in First Trimester Fetal Renal Malformations: The Role of Ultrasound in Diagnosis & Management Outline 1. Renal Anomalies Urinary Tract Dilation Aberrant Early Development Defects Terminal Maturation Alfred Abuhamad, M.D.

More information

MICTURITION CYSTO-URETHROGRAPHY IN THE INVESTIGATION OF URINARY TRACT DISEASES IN CHILDREN

MICTURITION CYSTO-URETHROGRAPHY IN THE INVESTIGATION OF URINARY TRACT DISEASES IN CHILDREN Arch. Dis. Childh., 1964, 39, 95. MICTURITION CYSTO-URETHROGRAPHY IN THE INVESTIGATION OF URINARY TRACT DISEASES IN CHILDREN BY R. PARKER ALLEN and EDMUND H. BURROWS* From the Children's Hospital, Denver,

More information

PROFESSIONAL SKILLS 1 3RD YEAR SEMESTER 6 RADIOGRAPHY. THE URINARY SYSTEM Uz. Fatema shmus aldeen Tel

PROFESSIONAL SKILLS 1 3RD YEAR SEMESTER 6 RADIOGRAPHY. THE URINARY SYSTEM Uz. Fatema shmus aldeen Tel PROFESSIONAL SKILLS 1 3RD YEAR SEMESTER 6 RADIOGRAPHY THE URINARY SYSTEM Uz. Fatema shmus aldeen Tel. 0925111552 Professional skills-2 THE URINARY SYSTEM The urinary system (review anatomy and physiology)

More information

Perineal Sonography in Diagnosis of an Ectopic Ureteric Opening Into the Urethra

Perineal Sonography in Diagnosis of an Ectopic Ureteric Opening Into the Urethra Case Series Perineal Sonography in Diagnosis of an Ectopic Ureteric Opening Into the Urethra S. Boopathy Vijayaraghavan, MD, DMRD Objective. To study the role of perineal sonography in the diagnosis of

More information

Outcome of Vesicoureteral Reflux in Infants: Impact of Prenatal Diagnosis

Outcome of Vesicoureteral Reflux in Infants: Impact of Prenatal Diagnosis Original Article Iran J Pediatr Aug 2013; Vol 23 (No 4), Pp: 439-444 Outcome of Vesicoureteral Reflux in Infants: Impact of Prenatal Diagnosis Hamid Mohammadjafari* 1, MD; Alireza Alam 2, MD; Saeed Mohammadi

More information

Bladder exstrophy and epispadias

Bladder exstrophy and epispadias Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families Bladder exstrophy and epispadias This leaflet explains about bladder exstrophy and epispadias and what to expect

More information

Obstetrics Content Outline Obstetrics - Fetal Abnormalities

Obstetrics Content Outline Obstetrics - Fetal Abnormalities Obstetrics Content Outline Obstetrics - Fetal Abnormalities Effective February 2007 10 16% renal agenesis complete absence of the kidneys occurs when ureteric buds fail to develop Or degenerate before

More information

PYELONEPHRITIS. Wendy Glaberson 11/8/13

PYELONEPHRITIS. Wendy Glaberson 11/8/13 PYELONEPHRITIS Wendy Glaberson 11/8/13 A 19mo infant girl was seen in the ED 3 days ago and diagnosed with a UTI. She was afebrile at the time and discharged on broad spectrum antibiotics. The child returns

More information

Vesicoureteral Reflux: The Difficulty of Consensus OR Why Can t We All Just get Along?

Vesicoureteral Reflux: The Difficulty of Consensus OR Why Can t We All Just get Along? Vesicoureteral Reflux: The Difficulty of Consensus OR Why Can t We All Just get Along? J Brandt MD MPH Pediatric Nephrology, UNMSOM Family Practice Grand Rounds 2/14/2012 Why do we worry about VUR? 3

More information

Pelvioureteric junction obstruction of the lower collecting system associated with incomplete ureteral duplication: A case report

Pelvioureteric junction obstruction of the lower collecting system associated with incomplete ureteral duplication: A case report Ped Urol Case Rep 2014;1(6):11-15 DOI:10.14534/PUCR.201468061 PUCR Ped Urol Case Rep PEDIATRIC UROLOGY CASE REPORTS ISSN: 2148 2969 Journal homepage: http://www.pediatricurologycasereports.com Pelvioureteric

More information

Pelvi-Ureteric Junction Obstruction Revisited

Pelvi-Ureteric Junction Obstruction Revisited Dr. Bimalendu Mukherjee was trained in Urology in the UK between 1956 to 1961. Upon return to India, he took up a teaching position in Calcutta National Medical College and ultimately retired as Professor

More information

10. Diagnostic imaging for UTI

10. Diagnostic imaging for UTI 10. Diagnostic imaging for UTI Key question: What is the most effective imaging test for the diagnosis of structural abnormalities of the urinary tract and/or kidney damage in children with UTI? Current

More information

Uroradiology Tutorial For Medical Students

Uroradiology Tutorial For Medical Students Uroradiology Tutorial For Medical Students Lesson 3: Cystography & Urethrography Part 1 American Urological Association Introduction Conventional radiography of the urinary tract includes several diagnostic

More information

Medical Management of childhood UTI and VUR. Dr Patrina HY Caldwell Paediatric Continence Education, CFA 15 th November 2013

Medical Management of childhood UTI and VUR. Dr Patrina HY Caldwell Paediatric Continence Education, CFA 15 th November 2013 Medical Management of childhood UTI and VUR Dr Patrina HY Caldwell Paediatric Continence Education, CFA 15 th November 2013 Terminology According to the current ICCS terminology guidelines Bladder and

More information

The University of Arizona Pediatric Residency Program. Primary Goals for Rotation. Nephrology

The University of Arizona Pediatric Residency Program. Primary Goals for Rotation. Nephrology The University of Arizona Pediatric Residency Program Primary Goals for Rotation Nephrology 1. GOAL: Understand the general pediatrician's role in diagnosis and management of hypertension in children.

More information

Vesicoureteral Reflux

Vesicoureteral Reflux What is the normal urinary tract? The kidneys filter the blood and extract waste products from the blood to make urine. Urine passes from the kidneys, down the ureters, and into the bladder for storage

More information

Urine Blockage in Newborns

Urine Blockage in Newborns Urine Blockage in Newborns National Kidney and Urologic Diseases Information Clearinghouse What is the urinary tract? The urinary tract is the body s drainage system for removing wastes and extra fluid.

More information

Vesico Ureteric Reflux (VUR)

Vesico Ureteric Reflux (VUR) Vesico Ureteric Reflux (VUR) WINSTON HELEN Author: Paediatric Department Document Number: STHK0876 Version: 5 Review date: June 2020 How does the urinary system work? The urinary system consists of the

More information

Complication of long indwelling urinary catheter and stent COMPLICATION OF LONG INDWELLING URINARY CATHETER AND STENT

Complication of long indwelling urinary catheter and stent COMPLICATION OF LONG INDWELLING URINARY CATHETER AND STENT 151 COMPLICATION OF LONG INDWELLING URINARY CATHETER AND STENT Jain A 1 *, Srivastava R 1, Prasad A 1, Marwah K 1 1. Department of surgery, Subharti medical college, Meerut U.P. India Correspondence: Dr.

More information

Vesicoureteral reflux and reflux nephropathy

Vesicoureteral reflux and reflux nephropathy Vesicoureteral reflux and reflux nephropathy This infokid topic is for parents and carers about children s kidney conditions. Visit www.infokid.org.uk to find more topics about conditions, tests & diagnosis,

More information

Topic 2: Management of infants less than one year of age with vesicoureteral reflux

Topic 2: Management of infants less than one year of age with vesicoureteral reflux Topic 2: Management of infants less than one year of age with vesicoureteral reflux Contents Index patient... 2 Introduction... 2 Methodology... 3 Outcomes Analysis... 3 Summary... 8 References... 11 Copyright

More information

Clinical-Radiological management of congenital hydronephrosis.

Clinical-Radiological management of congenital hydronephrosis. Clinical-Radiological management of congenital hydronephrosis. Poster No.: C-0983 Congress: ECR 2015 Type: Authors: Keywords: DOI: Educational Exhibit M. Vidal, D. Llanos, E. Pallares, I. de la Pedraja,

More information

RENAL SCINTIGRAPHY IN THE 21 st CENTURY

RENAL SCINTIGRAPHY IN THE 21 st CENTURY RENAL SCINTIGRAPHY IN THE 21 st CENTURY 99m Tc- MAG 3 with zero time injection of Furosemide (MAG 3 -F 0 ) : A Fast and Easy Protocol, One for All Indications Clinical Experience Congenital Disorders PROTOCOL

More information

CYSTIC DISEASES of THE KIDNEY. Dr. Nisreen Abu Shahin

CYSTIC DISEASES of THE KIDNEY. Dr. Nisreen Abu Shahin CYSTIC DISEASES of THE KIDNEY Dr. Nisreen Abu Shahin 1 Types of cysts 1-Simple Cysts 2-Dialysis-associated acquired cysts 3-Autosomal Dominant (Adult) Polycystic Kidney Disease 4-Autosomal Recessive (Childhood)

More information

Obstructive Uropathy. PATHOPHYSIOLOGIC CHANGES UUO vs BUO. Arry Rodjani Urology Department Ciptomangunkusumo Hospital Jakarta

Obstructive Uropathy. PATHOPHYSIOLOGIC CHANGES UUO vs BUO. Arry Rodjani Urology Department Ciptomangunkusumo Hospital Jakarta Obstructive Uropathy PATHOPHYSIOLOGIC CHANGES UUO vs BUO Arry Rodjani Urology Department Ciptomangunkusumo Hospital Jakarta INTRODUCTION Obstructive uropathy refers to the functional or anatomic obstruction

More information

Vesicostomy as a Protector of Upper Urinary Tract in Long-Term Follow-Up

Vesicostomy as a Protector of Upper Urinary Tract in Long-Term Follow-Up Pediatric Urology Vesicostomy as a Protector of Upper Urinary Tract in Long-Term Follow-Up Alessandro Prudente, Leonardo Oliveira Reis, Rodrigo de Paula França, Márcio Miranda, Carlos Arturo Levi D ancona

More information

Urinary tract infections, renal malformations and scarring

Urinary tract infections, renal malformations and scarring Urinary tract infections, renal malformations and scarring Yaacov Frishberg, MD Division of Pediatric Nephrology Shaare Zedek Medical Center Jerusalem, ISRAEL UTI - definitions UTI = growth of bacteria

More information

Chan, IHY; Lam, WWM; Wong, KKY; Tam, PKH

Chan, IHY; Lam, WWM; Wong, KKY; Tam, PKH Title Letters to the editor Author(s) Chan, IHY; Lam, WWM; Wong, KKY; Tam, PKH Citation Journal Of Paediatrics And Child Health, 2010, v. 46 n. 6, p. 361-362 Issued Date 2010 URL http://hdl.handle.net/10722/92175

More information

Management issues in a patient of posterior urethral valve with Renal rickets

Management issues in a patient of posterior urethral valve with Renal rickets PEDIATRIC UROLOGY CASE REPORTS DOI: 10.14534/PUCR.2016114552 DOI: Open Access Management issues in a patient of posterior urethral valve with Renal rickets Ranjita Baksi 1, Saswat Patnaik 1, Daisy Karan

More information

Radiological abnormalities and complications of urinary tract infection among urine culture positive children

Radiological abnormalities and complications of urinary tract infection among urine culture positive children Original article: Radiological abnormalities and complications of urinary tract infection among urine culture positive children Dr Shradha Salunkhe, Dr Suhas Sodal, Dr Ashrita Jonnalagadda, Dr Sharad Agarkhedkar

More information

POSTNATAL MANAGEMENT OF PRENATAL OBSTRUCTIVE HYDRONEPHROSIS

POSTNATAL MANAGEMENT OF PRENATAL OBSTRUCTIVE HYDRONEPHROSIS Journal of Paediatric Surgeons of Bangladesh (2010) Vol. 1 (2): 132-136 Official organ of the Association of Paediatric Surgeons of Bangladesh Journal of Paediatric Surgeons of Bangladesh Original Article

More information

Giovanni Montini has documented that he has no relevant financial relationships to disclose or conflict of interest to resolve.

Giovanni Montini has documented that he has no relevant financial relationships to disclose or conflict of interest to resolve. Giovanni Montini has documented that he has no relevant financial relationships to disclose or conflict of interest to resolve. Imaging in Pediatric UTI Giovanni Montini Milano, Italy giovanni.montini@unimi.it

More information

Current Trends in Pediatric GU Imaging European Perspective

Current Trends in Pediatric GU Imaging European Perspective Current Trends in Pediatric GU Imaging European Perspective Pierre-Hugues Vivier, MD, PhD CHU C. Nicolle, Rouen, France Générale de Santé, Hôpital Privé de l Estuaire, Le Havre, France 1.6% of boys / 7.8%

More information

Pediatric Ure-Radiology*

Pediatric Ure-Radiology* Pediatric Ure-Radiology* HERMAN GROSSMAN, M.D. Professor of Radiology and Pediatrics, Duke University Medical Center, Durham, North Carolina "Routine" radiologic studies do not, often enough, concentrate

More information

Editorial. A Changing Scenario in Our Understanding of Vesicoureteral Reflux in Children

Editorial. A Changing Scenario in Our Understanding of Vesicoureteral Reflux in Children Editorial A Changing Scenario in Our Understanding of Vesicoureteral Reflux in Children In this issue of the Journal is an article on the long-term clinical outcome of primary vesicoureteral reflux (VUR)

More information

The Management of Ureteropelvic Junction Obstruction Presenting with Prenatal Hydronephrosis

The Management of Ureteropelvic Junction Obstruction Presenting with Prenatal Hydronephrosis Review Special Issue: Pre- and Postnatal Management of Hydronephrosis TheScientificWorldJOURNAL (2009) 9, 400 403 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2009.51 The Management of Ureteropelvic Junction

More information

MICTURATING CYSTOURETHROGRAPHY- A PICTORIAL ESSAY

MICTURATING CYSTOURETHROGRAPHY- A PICTORIAL ESSAY PICTORIAL REVIEW MICTURATING CYSTOURETHROGRAPHY- A PICTORIAL ESSAY Palle Lalitha, 1 M. Ch. Balaji Reddy, 1 K. Jagannath Reddy, 1 Vijaya Kumari 2 1 2 Department of Radiology, Focus Diagnostic Center, Punjagutta,

More information

Fetal Renal Malformations: The Role of Ultrasound in Diagnosis & Management

Fetal Renal Malformations: The Role of Ultrasound in Diagnosis & Management Fetal Renal Malformations: The Role of Ultrasound in Diagnosis & Management 12 weeks Alfred Abuhamad, M.D. Eastern Virginia Medical School 13 weeks 2nd trimester Medullary pyramids Renal Sinus Cortex 2nd

More information

What s not! Imaging i.e CT scan, Sonography to localize testes. Find testes with imaging= surgery/orchiopexy

What s not! Imaging i.e CT scan, Sonography to localize testes. Find testes with imaging= surgery/orchiopexy What s Hot and What s Not in Pediatric Urology Undescended Testes Laurence Baskin, UCSF Children s Hospital Early Surgery MRI in UDT Obesity to localize Testes Bilateral Disease Non-Palpable Testes Refer

More information

UTIs in children ( with controversies ) By Dr. Lindokuhle Mahlase

UTIs in children ( with controversies ) By Dr. Lindokuhle Mahlase UTIs in children ( with controversies ) By Dr. Lindokuhle Mahlase Epidemiology By age 7 years, 8 % of girls and 2 % of boys will have had a UTI. Most infections occur in the first 2 years of life ; boys

More information

Long-Term Clinical Follow up of Children with Primary Vesicoureteric Reflux. C.K. Abeysekara, B.M.C.D. Yasaratna and A.S.

Long-Term Clinical Follow up of Children with Primary Vesicoureteric Reflux. C.K. Abeysekara, B.M.C.D. Yasaratna and A.S. Brief Reports Long-Term Clinical Follow up of Children with Primary Vesicoureteric Reflux C.K. Abeysekara, B.M.C.D. Yasaratna and A.S.Abeyagunawardena From the Department of Pediatrics, Faculty of Medicine,

More information

Fig. 2 Lateral view of the retrograde urethrogram. wall appeared to be normal. Haematological and

Fig. 2 Lateral view of the retrograde urethrogram. wall appeared to be normal. Haematological and Medical Education Singapore Med J 2010; 51(4) 352 CME Article Clinics in diagnostic imaging (130) Khan R A, Wahab S, Ullah E Fig. I Anteroposterior view of the retrograde urethrogram. CASE PRESENTATION

More information

Postnatal Imaging of Antenatal Hydronephrosis

Postnatal Imaging of Antenatal Hydronephrosis Review Special Issue: Pre- and Postnatal Management of Hydronephrosis TheScientificWorldJOURNAL (2009) 9, 393 399 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2009.50 Postnatal Imaging of Antenatal Hydronephrosis

More information

Clinics in Diagnostic Imaging (61)

Clinics in Diagnostic Imaging (61) Singapore Med J 2001 Vol 42(5) : 233-237 M e d i c a l E d u c a t i o n Clinics in Diagnostic Imaging (61) K B J Sheah, S K H Yip, V T Joseph Fig. 1a Control abdominal radiograph. Fig. 1b Coned oblique

More information

Vesicoureteral Reflux in Neonates with Hydronephrosis; Role of Imaging Tools

Vesicoureteral Reflux in Neonates with Hydronephrosis; Role of Imaging Tools Original Article Iran J Pediatr Dec 2009; Vol 19 (No 4), Pp:347-353 Vesicoureteral Reflux in Neonates with Hydronephrosis; Role of Imaging Tools Hamid Mohammadjafari 1, MD; Alireza Alam* 2,MD; Mehrnoosh

More information

UPJO. Fatemeh_ yahoo.com

UPJO.   Fatemeh_ yahoo.com * DTPA IV III I E-mail: Fatemeh_ Dorre @ yahoo.com * DTPA III IV DTPA : DTPA,, I II TC99 TC99 1. Elder JS. Urologic disorders in infants and children. In: Behrman RE, kliegman RM, Jenson HB, editors. Nelson

More information

RENAL FAILURE IN CHILDREN Dr. Mai Mohamed Elhassan Assistant Professor Jazan University

RENAL FAILURE IN CHILDREN Dr. Mai Mohamed Elhassan Assistant Professor Jazan University RENAL FAILURE IN CHILDREN Dr. Mai Mohamed Elhassan Assistant Professor Jazan University OBJECTIVES By the end of this lecture each student should be able to: Define acute & chronic kidney disease(ckd)

More information

Genetics in Nephrology. Saeid Morovvati Associate Professor of BMSU Director of Biogene Laboratory

Genetics in Nephrology. Saeid Morovvati Associate Professor of BMSU Director of Biogene Laboratory Genetics in Nephrology Saeid Morovvati Associate Professor of BMSU Director of Biogene Laboratory Genetics in: A. Congenital Anomalies of the Kidney and Urinary Tract B. Cystic Diseases of the Kidney C.

More information

Long-Term Urinary Bladder Function Following Unilateral Refluxing Low Loop Cutaneous Ureterostomy

Long-Term Urinary Bladder Function Following Unilateral Refluxing Low Loop Cutaneous Ureterostomy www.kjurology.org http://dx.doi.org/.4/kju... Pediatric Urology LongTerm Urinary Bladder Function Following Unilateral Refluxing Low Loop Cutaneous Ureterostomy Dorit E Zilberman, Jacob Golomb, am D Kitrey,

More information

Large spectrum of complete urinary collecting system duplication exemplified by cases. Pictorial essay.

Large spectrum of complete urinary collecting system duplication exemplified by cases. Pictorial essay. Pictorial essay Med Ultrason 2013, Vol. 15, no. 4, 315-315 DOI: 10.11152/mu.2013.2066.154.of2 Large spectrum of complete urinary collecting system duplication exemplified by cases. Pictorial essay. Otilia

More information

Congenital midureteric stricture: A rare entity in pediatric patient

Congenital midureteric stricture: A rare entity in pediatric patient PEDIATRIC UROLOGY CASE REPORTS DOI: 10.14534/PUCR.2016622492 DOI: Open Access Congenital midureteric stricture: A rare entity in pediatric patient Prashant Sadashiv Patil, Gupta Abhaya, Kothari Paras L,

More information

Uroradiology For Medical Students

Uroradiology For Medical Students Uroradiology For Medical Students Lesson 4: Cystography & Urethrography - Part 2 American Urological Association Review Cystography is useful in evaluating the bladder, the urethra and the competence of

More information

KS Sunny Tse 1, LS Wong 1, TW Fan 1, KY Kwok 1, W Chan 2, MWY Leung 3, NSY Chao 3, TK Tsang 1, HS Fung 1, KW Tang 1, SCH Chan 1

KS Sunny Tse 1, LS Wong 1, TW Fan 1, KY Kwok 1, W Chan 2, MWY Leung 3, NSY Chao 3, TK Tsang 1, HS Fung 1, KW Tang 1, SCH Chan 1 KS Sunny Tse 1, LS Wong 1, TW Fan 1, KY Kwok 1, W Chan 2, MWY Leung 3, NSY Chao 3, TK Tsang 1, HS Fung 1, KW Tang 1, SCH Chan 1 1 Department of Radiology and Imaging; 2 Department of Paediatrics; 3 Division

More information