Vesicoureteral Reflux and Clinical Outcomes in Infants With Prenatally Detected Hydronephrosis

Abstract

No AccessJournal of UrologyReflux1 Oct 2002Vesicoureteral Reflux and Clinical Outcomes in Infants With Prenatally Detected Hydronephrosis M. Michele Brophy, Paul F. Austin, Yan Yan, and Douglas E. Coplen M. Michele BrophyM. Michele Brophy More articles by this author , Paul F. AustinPaul F. Austin More articles by this author , Yan YanYan Yan More articles by this author , and Douglas E. CoplenDouglas E. Coplen More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64396-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the incidence of vesicoureteral reflux and urinary tract infections in infants with prenatally detected hydronephrosis. Materials and Methods: We retrospectively reviewed the charts of children referred to our hospital for evaluation of prenatally detected hydronephrosis between 1992 and 1998. Measured variables included ultrasound and voiding cystourethrogram findings, and infectious and clinical reflux outcomes. Results: Vesicoureteral reflux was identified in 40 of 234 infants (21%), including 24% of males and 13% of females. A significant correlation was found between the degree of hydronephrosis and incidence of reflux. Urinary tract infections were uncommon and identified in 7.5% of children on prevention for reflux and 4% with normal voiding cystourethrogram. In the majority (58%) of cases reflux resolved with medical management. Conclusions: The incidence of reflux increases with greater degrees of sonographic dilatation but a normal ultrasound does not exclude reflux and, therefore, voiding cystourethrogram is recommended in all children with prenatally detected hydronephrosis. Since urinary tract infections are uncommon with prevention, antibiotics should be continued until reflux resolves and/or hydronephrosis significantly improves. References 1 : Can careful ultrasound examination of the urinary tract exclude vesicoureteric reflux in the neonate?. Br J Radiol1997; 70: 977. Google Scholar 2 : Pyelectasis and hydronephrosis in the newborn and infant. Acta Paediatr2000; 89: 900. Google Scholar 3 : The role of micturating cystourethrography in antenatally detected mild hydronephrosis. Pediatr Radiol1998; 28: 152. Google Scholar 4 Jaswon M.S. Dibble L. Puri S. Prospective study of outcome in antenatally diagnosed renal pelvis dilatation. Arch Dis Child Fetal Neonatal Ed, 80: F135, 1999 Google Scholar 5 : Outcome of primary vesicoureteric reflux detected following fetal renal pelvic dilatation. J Paediatr Child Health2000; 36: 569. Google Scholar 6 : Perception of fear, distress and pain by parents of children undergoing a micturating cystourethrogram: a prospective study. J Paediatr Child Health2001; 37: 271. Google Scholar 7 : Vesicoureteral reflux in infants with prenatal hydronephrosis confirmed at birth: racial differences. J Urol1999; 161: 248. Link, Google Scholar 8 : Does every patient with prenatal hydronephrosis need voiding cystourethrography?. J Urol1999; 162: 1218. Link, Google Scholar 9 : Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol1993; 23: 478. Google Scholar 10 : Sibling reflux: a dual center retrospective study. J Urol1996; 156: 677. Link, Google Scholar 11 : The natural history of neonatal vesicoureteral reflux associated with antenatal hydronephrosis. J Urol2000; 164: 1057. Link, Google Scholar 12 : A multicenter outcomes analysis of patients with neonatal reflux presenting with prenatal hydronephrosis. J Urol1999; 162: 1203. Link, Google Scholar 13 : Complications of voiding cystourethrography in the evaluation of infants with prenatally detected hydronephrosis. J Urol1999; 162: 1221. Link, Google Scholar 14 : Re: Vesicoureteral reflux in infants with prenatal hydronephrosis confirmed at birth: racial differences. J Urol1999; 162: 1705. Link, Google Scholar 15 : A high multiethnic incidence of reflux in the screening of antenatal hydronephrosis. J Urol, suppl.2000; 163: 67. abstract 293. Google Scholar From the Division of Pediatric Urology, St. Louis Children’s Hospital and Washington University School of Medicine, St. Louis, Missouri© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 168Issue 4 Part 2October 2002Page: 1716-1719 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsurinary tract infectionshydronephrosis, vesico-ureteral refluxprenatal diagnosisMetricsAuthor Information M. Michele Brophy More articles by this author Paul F. Austin More articles by this author Yan Yan More articles by this author Douglas E. Coplen More articles by this author Expand All Advertisement PDF DownloadLoading ...