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https://www.readbyqxmd.com/read/28098106/the-role-of-dynamic-renal-scintigraphy-on-clinical-decision-making-in-hydronephrotic-children
#1
Seçil Arslansoyu Çamlar, Nazlı Deveci, Alper Soylu, Mehmet Atilla Türkmen, Derya Özmen, Gamze Çapakaya, Salih Kavukçu
Hydronephrosis may be related to an obstructive cause, ureteropelvic/uretero-vesical junction obstruction or nonobstructive [vesicoureteral reflux (VUR)]. When an obstructive pathology is considered, dynamic renal scintigraphy may help to predict whether it is a true obstruction or not. In this study, we aimed to determine the contribution of dynamic renal scintigraphy with [99] mTc-MAG-3 to the clinical decision-making for surgery in hydronephrotic children. Files of the patients evaluated by MAG-3 scintigraphy for antenatal (AH)/postnatal (PH) hydronephrosis between 1992 and 2014 were reviewed...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097262/lessons-learned-over-a-decade-of-pediatric-robotic-ureteral-reimplantation
#2
REVIEW
Minki Baek, Chester J Koh
The da Vinci robotic system has improved surgeon dexterity, ergonomics, and visualization to allow for a minimally invasive option for complex reconstructive procedures in children. Over the past decade, robot-assisted laparoscopic ureteral reimplantation (RALUR) has become a viable minimally invasive surgical option for pediatric vesicoureteral reflux (VUR). However, higher-than-expected complication rates and suboptimal reflux resolution rates at some centers have also been reported. The heterogeneity of surgical outcomes may arise from the inherent and underestimated complexity of the RALUR procedure that may justify its reclassification as a complex reconstructive procedure and especially for robotic surgeons early in their learning curve...
January 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28089295/inter-rater-reliability-of-distal-ureteral-diameter-ratio-compared-to-grade-of-vur
#3
A R Swanton, A M Arlen, S E Alexander, K Kieran, D W Storm, C S Cooper
INTRODUCTION AND OBJECTIVE: Management of vesicoureteral reflux (VUR) remains controversial, and reflux grade constitutes an important prognostic factor. Recent work has suggested that distal ureteral diameter ratio (UDR) is a predictive factor relative to clinical outcome independent of grade. Previous studies have noted significant inter-rater variability with grading of VUR. The present study compared inter-rater reliability of reflux grade and UDR in children with primary VUR. STUDY DESIGN: Four pediatric urologists independently reviewed, in a blinded fashion, voiding cystourethrograms...
December 1, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28087926/urinary-tract-infections-in-infants-and-children
#4
Theresa A Schlager
Urinary tract infections (UTI) are one of the most common infections in children and symptoms may be nonspecific. The risk of renal scarring is highest in children under 1 year of age with febrile UTI and high-grade vesicoureteral reflux (VUR). Although treatment of UTI is usually straightforward, given increased rates of antimicrobial resistance worldwide, the choice of treatment for pediatric UTI should be guided by community resistance patterns whenever feasible. The benefit of antimicrobial prophylaxis after first UTI and/or in the presence of VUR remains controversial, but a recent meta-analysis supports continuous antimicrobial prophylaxis in children with VUR, indicating a need for more research in this area...
October 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/28087230/the-impact-of-obesity-on-febrile-urinary-tract-infection-and-renal-scarring-in-children-with-vesicoureteral-reflux
#5
H J Byun, J Y Ha, W Jung, B H Kim, C H Park, C I Kim
INTRODUCTION: It has become clear that obesity is associated with a variety of infectious diseases, including urinary tract infection (UTI) and renal scarring. OBJECTIVE: The aim of this study was to evaluate the association between obesity and the degree of febrile UTI (fUTI) and renal scarring in children with vesicoureteral reflux (VUR), and to stratify the results into obesity subcategories. STUDY DESIGN: A total of 186 patients were diagnosed with VUR between January 2002 and December 2008...
October 1, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28051910/transperitoneal-intravesical-technique-for-laparoscopic-ureteral-reimplantation-to-treat-terminal-ureteral-stenosis
#6
Bing-Sheng Li, Yao He, Zhi Chen, Zhao-Hui Wang, Zhi-Qiang Wen, Xiang Chen
OBJECTIVE: To describe a newly developed transperitoneal intravesical technique for laparoscopic ureteral reimplantation in patients with terminal ureteral stenosis. METHODS: Between July 2009 and May 2015, laparoscopic transperitoneal intravesical ureteral reimplantation was performed in 16 patients with terminal ureteral stenosis without vesicoureteral reflux (VUR). An incision was made in the superior bladder wall of the affected side with an electric hook. The bladder mucosa was then circumferentially cut away from the ureteral orifice to a distance of 0...
January 4, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28051222/contribution-of-ultrasound-scans-in-the-first-episode-of-urinary-tract-infection-in-children
#7
Manel Jellouli, Asma Ben Mansour, Kamel Abidi, Meriem Ferjani, Ouns Naija, Yousra Hammi, Chokri Zarrouk, Tahar Gargah
Background - Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (US) and voiding cystourethrography (VCUG). We propose to determine whether abnormalities found on US can help indicate the necessity of VCUG in children after the first urinary tract infection. Methods - A retrospective study included all children admitted with their first episode of urinary tract infection from January 2007 to December 2012...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28027609/prediction-of-high-grade-vesicoureteral-reflux-in-children-younger-than-2-years-using-renal-sonography-a-preliminary-study
#8
Sun Kyoung You, Jong Chun Kim, Won Hong Park, So Mi Lee, Hyun-Hae Cho
OBJECTIVES: To investigate the predictive value of renal sonography for vesicoureteral reflux (VUR) and the efficacy of renal sonography, technetium Tc 99m-labeled dimercaptosuccinic acid (DMSA) scanning, and a combination of the two for VUR screening in children younger than 2 years with a first episode of febrile urinary tract infection. METHODS: Thirty-eight patients younger than 2 years with a first febrile urinary tract infection were included in our study, which was conducted from April through October 2014...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27993711/late-onset-uretero-vesical-junction-obstruction-following-endoscopic-injection-of-bulking-material-for-the-treatment-of-vesico-ureteral-reflux
#9
David Ben-Meir, Zaher Bahouth, Sarel Halachmi
OBJECTIVE: To characterize patients who develop late obstruction after subureteral injection of bulking agent for the treatment of pediatric vesicoureteral reflux (VUR). METHODS: We retrospectively evaluated the medical records of all patients who underwent endoscopic injection for the correction of VUR during 2008-2015 in 2 centers in Israel: Bnai-Zion Medical Center, Haifa, and Schneider Children's Medical Center, Petah Tikva. Nine patients who developed late-onset obstruction were included in the study, and their data were reviewed and analyzed...
December 16, 2016: Urology
https://www.readbyqxmd.com/read/27990783/radiation-exposure-during-videourodynamics-establishing-risk-factors
#10
Benjamin M Brucker, Lysanne Campeau, Eva Fong, Sidhartha Kalra, Nirit Rosenblum, Victor W Nitti
OBJECTIVES: The use of fluoroscopy during urodynamics can be helpful in the evaluation of patients with lower urinary tract dysfunction. However, fluoroscopy introduces the potential hazards of ionizing radiation, including malignancy. In this study we analyzed the data for radiation exposure during videourodynamic study (VUDS) at our center; we have also tried to establish the factors associated with increased exposure to radiation during VUDS. METHODS: We reviewed all VUDS from August 2010 to May 2011...
December 19, 2016: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/27990422/premature-destruction-of-microbubbles-during-voiding-urosonography-in-children-and-possible-underlying-mechanisms-post-hoc-analysis-from-the-prospective-study
#11
Maciej Piskunowicz, Dominik Swieton, Dorota Rybczynska, Arkadiusz Szarmach, Edyta Szurowska, Menno Pruijm
The aim of this study is to describe premature microbubbles destruction with contrast-enhanced voiding urosonography (ce-VUS) in children using 2nd-generation ultrasound contrast agents (UCA) and to hypothesize about the reason. 141 children (61 females and 80 males) were included in the study, with mean age of 3.3 years (range 4 weeks-16.0 years), who underwent ce-VUS examination between 2011 and 2014. Premature destruction of the microbubbles in the urinary bladder during ce-VUS was observed in 11 children (7...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27989639/the-swedish-infant-high-grade-reflux-trial-bladder-function
#12
J Nordenström, U Sillen, G Holmdahl, T Linnér, E Stokland, S Sjöström
INTRODUCTION: It has been suggested that infants with high-grade vesicoureteral reflux (VUR) have lower urinary tract dysfunction (LUTD) that is characterised by large bladder capacity (BC) and increased post-void residual (PVR). However, most of these infants have normal or small BC in early infancy and develop large capacity during the first year of life. OBJECTIVE: This study aimed to see whether LUTD development during the infant years in children with high-grade VUR could be prevented by early reflux resolution...
November 30, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27988909/estimation-of-the-relationship-between-the-polymorphisms-of-selected-genes-ace-agtr1-tgf%C3%AE-1-and-gnb3-with-the-occurrence-of-primary-vesicoureteral-reflux
#13
Marcin Życzkowski, Joanna Żywiec, Krzysztof Nowakowski, Andrzej Paradysz, Władyslaw Grzeszczak, Janusz Gumprecht
PURPOSE: Etiopathogenesis of VUR is composite and not fully understood. Many data indicate the importance of genetic predisposition. The aim of this study was to establish the relationship of selected polymorphisms: 14094 polymorphism of the ACE, polymorphism rs1800469 of TGFβ-1, rs5443 gene polymorphism of the GNB3 and receptor gene polymorphism rs5186 type 1 AGTR1 with the occurrence of the primary vesicoureteral reflux. MATERIAL: The study included 190 children: 90 with the primary VUR confirmed with the voiding cystourethrogram and excluded secondary VUR and a control group of 100 children without a history of the diseases of the genitourinary tract...
December 17, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27967216/randomized-study-of-ureteral-catheter-vs-double-j-stent-in-tubeless-minimally-invasive-percutaneous-nephrolithotomy-patients
#14
Yizhou Zhou, Jianguo Zhu, Alberto Gurioli, Dongbo Yuan, Jiawei Luo, Zhilin Li, Wei Zhang, Shiwei Xiao, Yongda Liu
OBJECTIVE: To prospectively analyze and compare the outcomes of using externalized ureteral catheter (EUC) vs Double-J ureteral stent (DJ) in tubeless minimally invasive percutaneous nephrolithotomy (MPCNL). PATIENTS AND METHODS: A total of 109 patients underwent tubeless MPCNL in our institute and have been enrolled into this study. Fifty-six and 53 patients had EUC and DJ positioning at the conclusion of the procedure, respectively. The two approaches have been compared for operative time, intraoperative blood loss, postoperative visual analogue pain scale (VAS) score, analgesic requirement, stent-related symptoms, hospital stay, degree of vesicoureteral reflux (VUR) on the operative side, and complications according to the modified Clavien system...
January 12, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/27964829/the-role-of-voiding-cystourethrography-in-asymptomatic-unilateral-isolated-ureteropelvic-junction-obstruction-a-retrospective-study
#15
Mohammed S ElSheemy, Waleed Ghoneima, Mohammad Abdelwahhab, Waseem Aboulela, Kareem Daw, Ahmed M Shouman, Ahmed I Shoukry, Mohamed El Ghoneimy, Hany A Morsi, Hesham Badawy
INTRODUCTION: The presence of concomitant vesicoureteric reflux (VUR) and ureteropelvic junction obstruction (UPJO) is uncommon. Nevertheless, the reported VUR coexisting with asymptomatic unilateral isolated hydronephrosis (AUIH) requiring pyeloplasty for correction of UPJO was of low grade and mostly resolved during conservative follow-up. Therefore, VCUG may be not indicated in these children except if voiding symptoms, urinary tract infection (UTI), dilated ureters, or bladder and ureteric abnormalities are suspected...
November 24, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27951542/critical-analysis-of-a-series-of-early-inguinal-ureterostomies-are-they-useful-and-how-well-are-they-tolerated
#16
Aurore Bouty, Yan Lefevre, Luke Harper, Antoine Tran, Pierre Vergnes, Eric Dobremez
INTRODUCTION: The study aimed to evaluate the advantages of temporary inguinal ureterostomy in the management of neonates with uropathies and early or recurrent pyelonephritis. PATIENTS AND METHODS: We performed a retrospective analysis of all patients who underwent ureterostomies between 1989 and 2012, with specific regards to indications and outcomes. We also performed a survey of parents to evaluate their acceptance of diversion. RESULTS: We included 18 patients (12 primary high-grade vesicoureteral reflux [VUR] and 6 primary obstructive megaureters [MUs])...
December 13, 2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27939835/vesicoureteral-reflux-index-predicting-primary-vesicoureteral-reflux-resolution-in-children-diagnosed-after-age-24-months
#17
Michael Garcia-Roig, Derrick E Ridley, Courtney McCracken, Angela M Arlen, Christopher S Cooper, Andrew J Kirsch
PURPOSE: The Vesicoureteral Reflux Index is a validated tool that reliably predicts spontaneous resolution of reflux, or 2 or more grades of improvement in patients diagnosed before age 24 months. We evaluated the Vesicoureteral Reflux Index in children older than 2 years. MATERIALS AND METHODS: Patients younger than 18 years who were diagnosed with primary vesicoureteral reflux after age 24 months and had 2 or more voiding cystourethrograms available were identified...
December 9, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27939178/establishing-a-standard-protocol-for-the-voiding-cystourethrography
#18
Dominic Frimberger, Stuart B Bauer, Mark P Cain, Saul P Greenfield, Andrew J Kirsch, Faridali Ramji, Maria-Gisela Mercado-Deane, Christoper S Cooper
The voiding cystourethrogram (VCUG) is a frequently performed test to diagnose a variety of urologic conditions, such as vesicoureteral reflux (VUR). The test results determine whether continued observation or an interventional procedure is indicated. VCUGs are ordered by many specialists and primary care providers, including pediatricians, family practitioners, nephrologists, hospitalists, emergency room physicians, and urologists. Current protocols for performing and interpreting a VCUG are based on the International Reflux Study in 1985...
December 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27919407/incidence-of-urinary-tract-infections-in-infants-with-antenatally-diagnosed-hydronephrosis-a-retrospective-single-center-study
#19
Sofia Visuri, Timo Jahnukainen, Seppo Taskinen
OBJECTIVE: To evaluate the incidence of urinary tract infections (UTIs) in infants with antenatal hydronephrosis (AHN). MATERIALS AND METHODS: A cohort of AHN patients admitted to our institution between 2003 and 2013 were identified. Altogether 192 patients with nonrefluxing hydronephrosis (HN, n=135), nonrefluxing hydroureteronephrosis (HUN, n=21), or vesicoureteral reflux (VUR, n=36) were identified. Patients with complex anomalies or neonatal decompression of the urinary tract were excluded...
November 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27914584/outcome-of-poorly-functioning-kidneys-secondary-to-pujo-preserved-by-pyeloplast
#20
Yasir Ahmad Lone, Ram Samujh, Anish Bhattacharya, Ravi Prakash Kanojia
AIMS: To study the intermediate term to long-term functional status of kidneys with split renal function(SRF) <15% secondary to PUJO which are preserved by pyeloplasty and to find out whether these kidneys can recover or eventually need nephrectomy. METHODS: 24 patients with SRF<15% and undergoing pyeloplasty with or without prior percutaneous nephrostomy (PCN) were studied. Those with associated VUR, B/L disease and redo pyeloplasties were excluded. Follow up USG and EC scan were done at 3, 9 and 18months and yearly thereafter to document functional status after surgery...
November 26, 2016: Journal of Pediatric Surgery
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