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Pediatric hydronephrosis reflux vesicoureteric

Christopher S Cooper
The human body is an unfathomably intricate structure consisting of many connected and intertwined systems. This makes it impossible for therapeutic interventions to selectively target only one physiologic system without some impact or side effects on all the other systems. The resiliency of the human body modifies and disguises side effects, some of which may be undetectable for years and not apparent without scientific investigation. Pediatric urologists employ relatively few medications for the common conditions they treat and in general these consist of antibiotics, anticholinergics, and anesthetics...
June 17, 2017: Journal of Pediatric Urology
Raghu Prakash, Archana Puri, Rama Anand, Ajay K Jain, Brahmanand Lal, Vaibhav Garg
INTRODUCTION: Upper tract damage (UTD) is a life-threatening complication of neurogenic bladder (NB). Early identification of risk factors for UTD and institution of remedial measures may probably prevent UTD. The aim was to study the predictors of UTD in children 2 years or older with NB. METHOD: This cross-sectional, observational study over 2 years included 30 children. UTD was defined as serum creatinine of >1 mg/dL or society of fetal urology grade III-IV hydronephrosis or hydroureteronephrosis on ultrasonography or renal scars on (99)(m)technetium dimercaptosuccinic scan or subnormal glomerular filtration rate (GFR) for age...
March 22, 2017: Journal of Pediatric Urology
Seyithan Ozaydin, Suleyman Celebi, Ismail Caymaz, Cemile Besik, Birgul Karaaslan, Ozgur Kuzdan, Serdar Sander
BACKGROUND: To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system according to the international classification of VUR (ICVUR) and to evaluate whether VUR grading accuracy could be improved by renal ultrasonography (RU) according to the Society for Fetal Urology (SFU) grading system. OBJECTIVES: Therefore, this study assessed the accuracy of the current VCUG staging system by assessing inter-rater reliability among pediatric radiologists and urologists; it also evaluated whether accuracy is increased by RU without consensus (with respect to VCUG grading)...
September 2016: Nephro-urology Monthly
Catherine S Forster, Prasad Devarajan
Neutrophil gelatinase-associated lipocalin (NGAL) is best known as a non-invasive early marker of acute kidney injury (AKI). However, recent published reports have described additional utility of both plasma NGAL (pNGAL) and urine NGAL (uNGAL) in various pathologic conditions within the pediatric urinary tract, including urinary tract infection, vesicoureteral reflux (VUR), renal scarring, and obstructive uropathy. These two forms of NGAL have different applications related to their mechanisms of upregulation: pNGAL can serve as a marker of systemic inflammatory conditions, whereas uNGAL is specific for insults to the renal epithelium...
March 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Michael J Biles, Julia B Finkelstein, Mark V Silva, Sarah M Lambert, Pasquale Casale
INTRODUCTION: Robotic technology has been increasingly utilized for complicated reconstructive surgeries in pediatric urology, such as ureteroureterostomy (UU). The literature is limited regarding the performance of minimally invasive UU in children, and the existing published series utilize indwelling ureteral stents. We sought to report on our pediatric experience with robot-assisted laparoscopic (RAL)-UU using a temporary ureteral catheter in duplex systems with ureteral ectopia. METHODS: A retrospective chart review was performed of all pediatric patients who underwent RAL-UU at a single institution over a 2-year period...
October 2016: Journal of Endourology
Pankaj P Dangle, Omar Ayyash, Jathin Bandari, Audry Kang, Heidi A Stephany, Glenn M Cannon, Francis X Schneck, Michael C Ost
OBJECTIVE: To study the individual patient-related risk factors in those undergoing open corrective vesicoureteral reflux (VUR) surgery in a contemporary series. The management of VUR remains controversial, and the indications for open surgery has evolved from that of surgeon and patient preference to criteria involving breakthrough urinary tract infections and grade of VUR. MATERIALS AND METHODS: A retrospective study was performed, and patients undergoing open surgical repair for dilating VUR (grade III-V) from 2005 to 2014 were included...
January 2017: Urology
Tamar R Lubell, David Schnadower, Stephen B Freedman, Charles G Macias, Dewesh Agrawal, Nathan Kuppermann, Peter S Dayan
BACKGROUND: Few data exist on the presentations and clinical courses of infants with enterococcal urinary tract infections (UTI). The objective of this study was to compare the clinical presentation, sensitivity of urinalysis (UA) and Gram's stain, radiological abnormalities and adverse events of febrile infants with enterococcal UTIs to those with Gram-negative UTIs. METHODS: Retrospective study of febrile (≥38.0°C) infants 29-60 days of age with UTIs at 20 emergency departments...
September 2016: Pediatric Infectious Disease Journal
Alice Faure, Matthieu Peycelon, Pauline Lallemant, Georges Audry, Veronique Forin
PURPOSE: To describe the acceptance and efficacy of clean intermittent catheterization (CIC) in the management of lower urinary tract (LUT) dysfunction regardless of the age of the children and their degree of urethral sensation. MATERIALS AND METHODS: We retrospectively evaluated boys managed with CIC at a pediatric teaching hospital between 1992 and 2014. Age, urethral sensation, acceptance, efficacy in terms of continence and preserving upper urinary tract and genitourinary complications were reviewed in the medical records...
April 16, 2016: Urology Journal
Hiroshi Asanuma, Zenichi Matsui, Hiroyuki Satoh, Nobuyoshi Asai, Chizuko Nukui, Yujiro Aoki, Ryuichi Mizuno, Mototsugu Oya
PURPOSE: Vesicoureteral reflux is the most common urinary tract abnormality in children. Although voiding cystourethrography is the gold standard for diagnosing reflux, this approach is invasive. We evaluated color Doppler ultrasound measurement of ureteral jet angle as a noninvasive screening tool for detecting reflux. MATERIALS AND METHODS: We retrospectively evaluated 125 children (250 renal units) who presented with urinary tract infections or hydronephrosis...
June 2016: Journal of Urology
Da Min Choi, Tae Hoon Heo, Hyung Eun Yim, Kee Hwan Yoo
PURPOSE: To evaluate the practical applications of the diagnosis algorithms recommended by the American Academy of Pediatrics urinary tract infection (UTI) guideline. METHODS: We retrospectively reviewed the medical records of febrile UTI patients aged between 2 and 24 months. The patients were divided into 3 groups: group I (patients with positive urine culture and urinalysis findings), group II (those with positive urine culture but negative urinalysis findings), and group III (those with negative urine culture but positive urinalysis findings)...
September 2015: Korean Journal of Pediatrics
Prayong Vachvanichsanong, Pornsak Dissaneewate, Edward McNeil
AIM: To determine the nature of primary vesicoureteral reflux (VUR) and the association of VUR with hydronephrosis and renal damage. METHODS: The medical records of children ≤ 15 years diagnosed with VUR, attending the Department of Pediatrics, Prince of Songkla University, Thailand between 1987 and 2013 were reviewed. Renal ultrasound and technetium-99m dimercaptosuccinic acid renal scan (DMSA) results were examined to determine the severity of hydronephrosis and renal damage, respectively...
April 2016: Nephrology
Anne-Sophie Blais, Fannie Morin, Jonathan Cloutier, Katherine Moore, Stéphane Bolduc
INTRODUCTION: Various bulking agents are available for vesicoureteral reflux (VUR) endoscopic treatment, but their inconsistent success rates and costs are concerns for urologists. Recently, polyacrylamide hydrogel (PAHG) has been shown to have a good overall success rate, which seems comparable to dextranomer hyaluronic acid (Dx/HA), currently the most popular bulking agent. Our objective was to compare the short-term success rate of PAHG and Dx/HA for VUR endoscopic treatment in children...
May 2015: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Nora G Lee, Sean T Corbett, Kaitlan Cobb, George C Bailey, Amy S Burns, Craig A Peters
PURPOSE: Ureteroureterostomy (UU) is a useful surgical option for the management of duplication anomalies as well as obstructed single system ureters for children. We aimed to evaluate the safety, efficacy, and outcomes of robot-assisted laparoscopic UU (RALUU) compared with open UU (OUU) in the pediatric population. PATIENTS AND METHODS: A retrospective review was performed at two institutions including six surgeons' experience with all cases of RALUU and OUU from January 2005 to June 2014...
November 2015: Journal of Endourology
Hassib Narchi, Muhaned Marah, Asad Aziz Khan, Abdulla Al-Amri, Amar Al-Shibli
OBJECTIVE: In a historical cohort of children with a urinary tract infection (UTI) who had already undergone all the imaging procedures, the aim was to determine renal tract abnormalities which would have been missed had we implemented the new guidelines from the National Institute for Health and Care Excellence in the United Kingdom (NICE) or the American Academy of Pediatrics (AAP). MATERIAL AND METHODS: After a UTI episode, forty-three children (28 females, 65%) aged between 2 months and 2 years presenting at two general hospitals with a febrile UTI before 2008 underwent all the recommended imaging studies predating the new guidelines...
October 2015: Journal of Pediatric Urology
Zachary N Gordon, Daryl J McLeod, Brian Becknell, D Gregory Bates, Seth A Alpert
PURPOSE: The 2011 American Academy of Pediatrics clinical practice guideline for childhood febrile urinary tract infection recommends voiding cystourethrography if renal and bladder ultrasound reveals hydronephrosis, scarring or "other findings" that suggest high grade vesicoureteral reflux. We sought to determine if the finding of uroepithelial thickening indicates greater risk of high grade vesicoureteral reflux and whether uroepithelial thickening improves the screening value of renal and bladder ultrasound...
October 2015: Journal of Urology
Vvs Chandrasekharam, Harish Jayaram
AIM: Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsilateral ureteroureterostomy (LIUU) for duplex anomalies. PATIENTS AND METHODS: The data of children who underwent LIUU was reviewed for demographic parameters, clinical and operative details, follow-up and results...
January 2015: Journal of Indian Association of Pediatric Surgeons
A Vachharajani, G J Vricella, T Najaf, D E Coplen
OBJECTIVE: The 2011 American Academy of Pediatrics (AAP) guidelines address imaging after initial febrile urinary tract infection (UTI) in infants >2 months of age. We sought to determine the frequency of upper urinary tract anomalies (hydronephrosis and vesicoureteral reflux (VUR)) in hospitalized premature infants with UTI. STUDY DESIGN: We retrospectively reviewed the electronic medical records of neonatal intensive care unit (NICU) admissions at a tertiary care children's hospital between 1 January 2006 and 31 December 2010...
May 2015: Journal of Perinatology: Official Journal of the California Perinatal Association
Natasha Brownrigg, Julia Pemberton, Kizanee Jegatheeswaran, Jorge DeMaria, Luis H Braga
PURPOSE: We determined the feasibility of a definitive trial comparing the effectiveness of group vs individual urotherapy for children with bladder-bowel dysfunction. MATERIALS AND METHODS: Children 6 to 10 years old with bladder-bowel dysfunction were recruited during the course of 1 year. Feasibility data on screening, eligibility, recruitment and protocol compliance rates were collected. Patients with high grade hydronephrosis, vesicoureteral reflux or learning disabilities and those who had previously undergone urotherapy were excluded...
April 2015: Journal of Urology
Raghad J Ali, Firyal H Al-Obaidi, Hala S Arif
OBJECTIVES: To assess urinary NAG/ urinary creatinine (NAG/ Cr) ratio in patients with urological abnormalities (normal and abnormal ultrasonography) and compare it with normal healthy children. METHODS: A prospective study was conducted from November 2012 to April 2013. Urine samples were collected from 70 patients with various urological abnormalities, and from 40 healthy control groups, their age range (1 month-13 years). Children who were admitted to Emergency Pediatric department, Children Welfare Teaching Hospital / Medical City Complex, Baghdad, Iraq...
July 2014: Oman Medical Journal
Emanuela Altobelli, Simona Gerocarni Nappo, Michele Guidotti, Paolo Caione
Although the diagnosis of vesicoureteral reflux and of reflux nephropathy is a well-established and shared procedure, its treatment nowadays is still very controversial. New developments on the knowledge of pathophysiology of renal damage associated to reflux opened the way towards a different diagnostic work-up and different therapeutic approaches. Recently, the "top-down" diagnostic approach has gained wider interest, versus the "down-top" protocol. The attention has recently focused on the renal parenchyma damage and less interest has been given to the presence and the radiological degree of vesicoureteral reflux...
April 2014: Urologia
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