Urinary bladder volume and pressure at reflux as prognostic factors of vesicoureteral reflux outcome

Papachristou, Fotis; Printza, Nicoleta; Doumas, Argyrios; Koliakos, George

doi:10.1007/s00247-004-1211-y

Cited by 17 publications

(4 citation statements)

References 11 publications

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“…14 ) ( 2 ). As published, VUR with low-pressure during early filling is associated with poor resolution and increased risk for acute pyelonephritis ( 19 20 ).…”

Section: Discussionmentioning

confidence: 99%

The ABCs of Voiding Cystourethrography

Kim

Cho

Lee

et al. 2020

J Korean Soc Radiol

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Voiding cystourethrography (VCUG) demonstrates the anatomy of the urinary system and is used to detect the presence/absence of vesicoureteral reflux. It is the most important modality for urological fluoroscopic examination in children. For improved patient care, it is important to understand and perform VCUG appropriately. Therefore, an in-depth review of VCUG protocols and techniques has been presented herein. In addition, tips, tricks, and pitfalls associated with the technique have also been addressed.

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“…14 ) ( 2 ). As published, VUR with low-pressure during early filling is associated with poor resolution and increased risk for acute pyelonephritis ( 19 20 ).…”

Section: Discussionmentioning

confidence: 99%

The ABCs of Voiding Cystourethrography

Kim

Cho

Lee

et al. 2020

J Korean Soc Radiol

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“…The occurrence of reflux according to filling bladder volumes (7,13) and reflux intensities (13) was previously defined. Additionally, we defined the bladder volume at maximal reflux and used that definition in this study.…”

Section: Discussionmentioning

confidence: 99%

“…The correlation between renal scarring and VUR has been shown to vary between 23% and 75% and is higher in patients with a high grade of VUR (8-11). The prevalence of renal damage is higher in patients with severe reflux (7,12,13). Therefore, children with high grades of VUR must be carefully managed, treated, and followed up to achieve a better outcome in adulthood (3).…”

mentioning

confidence: 99%

“…In one study, urinary bladder volume and pressure at reflux were prognostic for the resolution of reflux (13); in another, reflux at low bladder volumes was associated with increased renal scarring (7). The ability to predict the prognosis for a particular patient at the time of diagnosis may lead to better treatment decisions and follow-up and may result in better outcomes.…”

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confidence: 99%

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New Quantitative Parameters for Evaluating Radionuclide Cystography and Their Value in Understanding the Physiology of Reflux

Özdoğan

Türkmen²,

Atasever³

et al. 2009

Journal of Nuclear Medicine Technology

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In this descriptive study of radionuclide cystography, timeactivity curves were generated from renal pelves with reflux and evaluated to reveal the physiology of the reflux. The generated new parameters were also evaluated for any correlation with the frequency of urinary tract infections and renal scarring. Methods: Thirty-two children with reflux to the renal pelvis (36 refluxing units) were included. Regions of interest were drawn on the pelves and bladder, and time-activity curves were generated. The first reflux phase, the bladder volume at first reflux, and the bladder volume at maximal reflux were defined, and reflux percentages were calculated. Dimercaptosuccinic acid (DMSA) scintigraphy findings and urinary tract infections were used for correlation. Results: New curves from the renal pelvis during bladder filling and bladder emptying were generated and their patterns classified. Episodic reflux to the pelvis was observed on time-activity curves, which demonstrated 4 different emptying patterns during voiding. These patterns were described in detail. Visually, residual activity was present in the renal pelves in 58.8% of patients. The mean number of urinary tract infections per year was 1.07 (range, 0-4; SD, 0.88). The DMSA findings were normal in 57.1% of the patients. Conclusion: We obtained and categorized some new time-activity curve patterns from renal pelves with reflux on radionuclide cystography. Discussing these patterns may help physicians understand the physiology of the reflux and the relationship between infections and reflux. Vesi coureteral reflux (VUR) is a predisposing factor for urinary tract infection (1), and up to 20%240% of patients with urinary tract infection have been shown to have reflux (2-4). The causes of renal scarring are multifactorial, and VUR has been declared to be one of the main risk factors (5). Early diagnosis of VUR and urinary tract infection is necessary to decrease renal scarring (3). VUR may result in hypertension and end-stage renal disease (3,6,7). The correlation between renal scarring and VUR has been shown to vary between 23% and 75% and is higher in patients with a high grade of VUR (8-11). The prevalence of renal damage is higher in patients with severe reflux (7,12,13). Therefore, children with high grades of VUR must be carefully managed, treated, and followed up to achieve a better outcome in adulthood (3).Radionuclide cystography, the preferred procedure for the follow-up of patients with VUR, allows continuous acquisitions and exposes patients to less radiation than does voiding cystourethrography (14).Some information that can be obtained from radionuclide cystography has been shown to correlate with prognosis. In one study, urinary bladder volume and pressure at reflux were prognostic for the resolution of reflux (13); in another, reflux at low bladder volumes was associated with increased renal scarring (7). The ability to predict the prognosis for a particular patient at the time of diagnosis may lead to better treatment decisions and follow-up...

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Vesicoureteral Reflux

Treves¹,

Willi²

Pediatric Nuclear Medicine/Pet

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Urinary bladder volume and pressure at reflux as prognostic factors of vesicoureteral reflux outcome

Abstract: VUR occurring at a bladder pressure of less than 20 cm H(2)O and a filling volume of less than 45% of the total bladder volume indicate a low probability for VUR resolution within the subsequent 36 months, in infants with known reflux.

Cited by 17 publications

References 11 publications

The ABCs of Voiding Cystourethrography

The ABCs of Voiding Cystourethrography

New Quantitative Parameters for Evaluating Radionuclide Cystography and Their Value in Understanding the Physiology of Reflux

Vesicoureteral Reflux

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