Upper Urinary Tract Dilation

Abstract

Upper urinary tract dilation (UUTD) including hydronephrosis (HN) and ureteral dilation (UD) is one of important complications in neurogenic bladder (NB) patients. The evaluation and management for UUTD is crucial for the prevention of chronic renal failure. In this chapter, a grading system for UUTD based on magnetic resonance urography (MRU) is described by the author, in an attempt to provide a more objective, intuitive, and understandable method for UUTD grading. The applications of the MRU-UUTD grading system and a comprehensive classification system for both lower urinary tract (LUT) and upper urinary tract (UUT) dysfunction in patients with NB are described as well. Because MRU-UUTD grading system provides an objective and comprehensive evaluation for UUTD, it can be used to evaluate UUT function and for longitudinal monitoring of UUTD. It also allows better clinical decision-making by identifying changes in the UUTD. It can also be used to follow-up treatment outcome. The inter- and intra-observer reliability of this novel MRU-UUTD grading system is good providing adequate evidence for broader clinical application.KeywordsUpper urinary tract dilationHydronephrosisUreteral dilationMagnetic resonance urographyMRI-based grading systemClassification system