Doppler-Assessed Ureteric Jet Frequency: A Valuable Predictor of Ureteric Obstruction

Hassan, Waqar; Sharif, Imran; Khalid, Salman; Ellahibux, Kausar; Sultan, Silmi; Waqar, Asma; Zohaib, Agha; Yousuf, Fakhir

doi:10.7759/cureus.18290

Cited by 6 publications

(5 citation statements)

References 25 publications

(42 reference statements)

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“…The absence or decreased frequency of ureteral jets may indicate urinary obstruction. The severity of ureteric obstruction can be determined by evaluating all jet dynamics, including velocity, duration, and frequency[ 64 ]. However, computed tomography is still the most diagnostic tool of Po-AKI due to benign and malignant causes[ 5 ].…”

Section: Diagnosismentioning

confidence: 99%

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Gadelkareem¹,

Abdelraouf²,

El-Taher³

et al. 2022

World J Nephrol

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There is a well-known relationship between malignancy and impairment of kidney functions, either in the form of acute kidney injury or chronic kidney disease. In the former, however, bilateral malignant ureteral obstruction is a surgically correctable factor of this complex pathology. It warrants urgent drainage of the kidneys in emergency settings. However, there are multiple controversies and debates about the optimal mode of drainage of the bilaterally obstructed kidneys in these patients. This review addressed most of the concerns and provided a comprehensive presentation of this topic from the recent literature. Also, we provided different perspectives on the management of the bilateral obstructed kidneys due to malignancy. Despite the frequent trials for improving the success rates and functions of ureteral stents, placement of a percutaneous nephrostomy tube remains the most recommended tool of drainage due to bilateral ureteral obstruction, especially in patients with advanced malignancy. However, the disturbance of the quality of life of those patients remains a major unresolved concern. Beside the unfavorable prognostic potential of the underlying malignancy and the various risk stratification models that have been proposed, the response of the kidney to initial drainage can be anticipated and evaluated by multiple renal prognostic factors, including increased urine output, serum creatinine trajectory, and time-to-nadir serum creatinine after drainage.

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Section: Diagnosismentioning

confidence: 99%

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Gadelkareem¹,

Abdelraouf²,

El-Taher³

et al. 2022

World J Nephrol

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“…18,19 Further studies have shown that the urinary jet flow velocity in the obstructive ureter is significantly lower than that in the non-obstructive side. [20][21][22]…”

Section: Discussionmentioning

confidence: 99%

“…Color Doppler examinations were first performed in patients with hydronephrosis with a urinary jet examination 18,19 . Further studies have shown that the urinary jet flow velocity in the obstructive ureter is significantly lower than that in the non‐obstructive side 20–22 …”

Section: Discussionmentioning

confidence: 99%

Color Doppler Ultrasound's Utility in Detecting Vesicoureteral Reflux Using the Ureteral Jet Angle

Zadeh

Sadeghi‐Bojd

Ansari‐Moghaddam

et al. 2022

J of Ultrasound Medicine

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Objectives This study hypothesizes using color Doppler ultrasound to measure ureteral jet angles (UJA) as a diagnostic screening tool for reflux. Methods The present prospective cohort study included 122 patients and 238 renal unit pediatric patients suspected of VUR who presented to our hospital between 2019 and 2021. All patients underwent ultrasonography and VCUG, and the UJA was measured color Doppler evaluation of the ureteral jet. The UJA was compared with the VCUG findings in patients with and without reflux. SPSS 26 was used to analyze the data. Results A total of 96 patients and 139 renal units exhibited reflux. The mean ureteral jet angle in refluxing units was 60.47 + 16.66 degrees, whereas, it was 42.59 + 13.26 degrees in non‐refluxing units, a significant difference between the two groups (P < .001). The mean ureteral jet angle was 42.59, 45.89, 60.32, 68.23, and 56.16, for reflux grading from 0 to 5 (except grade 1), respectively. The angle value in each reflux grade increased significantly except for grade 5. For reflux detection (grade I–V), a cut‐off angle of 50 degrees was associated with sensitivity and specificity of 70 and 79, respectively. Grade IV/V reflux can be diagnosed with a sensitivity of 70% and specificity of 84% using a cut‐off angle of 68 degrees or greater. Conclusions UJA detection via color Doppler ultrasound demonstrates high accuracy, is non‐invasive method can be utilized as an alternative primary diagnostic tool or in follow‐up cases of VUR in children.

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“…Consequently, considering reno ureteral stones as the most prominent case of obstructive uropathy, initial ultrasonography has been proven to have a similar efficacy to initial abdominopelvic CT with less associated radiation in high-risk diagnosis[ 35 ]. Additionally, with the use of Doppler Ultrasound, it is possible to evaluate the presence of ureteral jets in the bladder; the absence or decreased frequency of these suggests the presence of urinary obstruction[ 36 ].…”

Section: Etiology and Diagnostic Challengesmentioning

confidence: 99%

Obstructive uropathy: Overview of the pathogenesis, etiology and management of a prevalent cause of acute kidney injury

Pérez-Aizpurua,

Benavente,

Serrano

et al. 2024

World J Nephrol

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Obstructive uropathy is defined as the structural or functional interruption of urinary outflow at any level in the urinary tract. It is regarded as one of the most prevalent causes of acute kidney injury (AKI), accounting for 5%–10% of cases. Acute severe obstruction of the urinary tract is a potentially threatening situation for the kidneys and therefore requires prompt identification and management to relieve obstruction. The aim of the present article is to review and synthesize available evidence on obstructive uropathy, providing a clinical guideline for clinicians. A literature review on obstructive uropathy in the context of AKI was performed, focusing on the least clarified aspects regarding diagnosis and management. Recent literature searching was conducted in English and top-level evidence articles including systematic reviews, metanalyses and large series were prioritized. Acute obstruction of the urinary tract is a diagnostic and therapeutical challenge that may lead to important clinical complications together with direct structural and hemodynamic damage to the kidney. Early recognition of the leading cause and its exact location is essential to ensure prompt urinary drainage together with the most suitable drainage technique selection. A multidisciplinary approach, including urologists, nephrologists, and other medical specialties, is best suited to correctly manage concomitant hemodynamic changes, fluid and electrolyte imbalances, and other related issues. Obstructive uropathy is one of the leading causes of AKI. Recognition of patients suitable for early diversion and feasibility or adequate selection of the indicated technique is sometimes challenging. A thorough understanding of the physiopathology behind the development of urinary obstruction is vital for correct diagnosis and management.

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Doppler-Assessed Ureteric Jet Frequency: A Valuable Predictor of Ureteric Obstruction

Abstract: Objectives: To compare ureterovesical jet frequency in non-obstructed versus obstructed ureter secondary to ureteric stone using ultrasonography in patients presenting with ureteral stones.Study design: Cross-sectional prospective study.

Cited by 6 publications

References 25 publications

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Color Doppler Ultrasound's Utility in Detecting Vesicoureteral Reflux Using the Ureteral Jet Angle

Obstructive uropathy: Overview of the pathogenesis, etiology and management of a prevalent cause of acute kidney injury

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