Diuretic renography in hydronephrosis: a retrospective single-center study

ConclusionsThe combination of ultrasound and MAG3 provides the necessary anatomical and functional information to follow the degree of obstruction and to decide between surgical intervention and conservative follow-up. Our study supports a threshold of 20  mm rather than 15 mm for severe obstruction and a low DRF. An APD threshold greater than 15 mm did not have a predictive value in DRF estimation.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research

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This article will review the available evidence in relation to prevention of sepsis in cUTI, evaluating the risk factors associated with sepsis development. Published articles from January 2005 to September 2019 on UTIs and sepsis prevention in complicated UTIs were identified by using MEDLINE (National Library of Medicine Bethesda MD) and by reviewing the references of retrieved articles.Expert opinion: Prevention of sepsis relies on prompt and timely diagnosis of cUTI, early identification of the causative organism, removal of obstructions and source control, proper and adequate empirical/targeted antimicrobial treatment...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
We report the case of a 4-year-old boy who first presented with acute pyelonephritis at the age of 6 months. Diagnostic workup revealed high-grade bilateral vesicourethral reflux (VUR). At the age of 18 months, a bulking agent was used to treat bilateral VUR. Since the VUR persisted, an open bilateral Lich-Gregoir procedure was done at the age of 3 years. Immediately after surgery, he developed acute urinary retention with hydronephrosis that resolved with the placement of dwelling urinary catheter. After removal of the catheter urinary retention relapsed so placement of suprapubic urinary catheter was indicated since he d...
Source: European Journal of Pediatric Surgery Reports - Category: Surgery Authors: Tags: Case Report Source Type: research
A 63-year-old woman initially presented to a local urologist with a 9-month history of hematuria/vaginal bleeding followed by urinary retention. Computed tomographic imaging demonstrated a markedly distended urinary bladder with moderate bilateral hydronephrosis. Cystoscopy revealed no evidence of bladder tumor or urethral abnormality, and recurrent urinary tract infection was suspected. The patient developed worsened vaginal bleeding over a 6-month period, and anterior vaginal fullness was then appreciated on examination; she required a permanent indwelling catheter.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Gray Zone Source Type: research
Abstract INTRODUCTION: We aimed to evaluate the impact of non-refluxing hydroureter on the initial management of high-grade hydronephrosis (HGH) management. Moreover, we evaluated the occurrence of febrile urinary tract infection (FUTI) and surgical intervention for conservatively managed units. METHODS: Patients' charts with postnatal hydronephrosis from 2008‒2014 were retrospectively reviewed. We included patients who presented in the first year of life. All included patients had HGH (Society of Fetal Ultrasound [SFU] grades3 and 4) and all were non-refluxing using voiding cystourethrogram (VCUG). We cate...
Source: Canadian Urological Association Journal - Category: Urology & Nephrology Authors: Tags: Can Urol Assoc J Source Type: research
Publication date: Available online 21 September 2019Source: Actas Urológicas Españolas (English Edition)Author(s): O. Yazici, A. Kafkasli, A. Erbin, M. Bilal Hamarat, A. Cubuk, O. Sarilar, K. SaricaAbstractPurposeTo evaluate the effect of JJ stents on SWL treatment of moderate (15–25 mm) renal pelvic stones.Materials and methodsBetween January 2016 and December 2017, a total of 152 adult patients who were planned to undergo SWL for a single radiopaque renal pelvic stone were included in the study. Patients with solitary kidney, congenital abnormality, skeletal tract abnormalities, previous urinary ...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
​BY MATTHEW WU, &DEANDRE WILLIANS, MDA 2-year-old girl presented to the emergency department for abdominal pain with urination. She had been diagnosed with a urinary tract infection three days earlier, and was in the process of completing a course of antibiotics.The pain with urination made it difficult to void urine even when soaking in warm baths, according to the patient's parents. Her mother said the patient had to be bribed to drink anything. Their daughter did not urinate for 14 hours before arriving at our ED. They were concerned about dehydration due to the lack of fluid intake. The patient also refused to ta...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
​Prepubertal boys who present to the emergency department with dysuria are uncommon. The adult with burning on urination is assumed to have a sexually transmitted disease, but of course that diagnosis should not be high on your list for boys.In fact, infectious urethritis in children is quite uncommon unless there is premature sexual activity or sexual abuse by an adult. Unfortunately, a variety of noninfectious urethral pathologies may mimic infectious urethritis in children. A urinary tract infection in a prepubertal boy is an infectious cause of dysuria. Those infections, however, rarely present with the isolated symp...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
We present the clinical course of a 10 years old child with diagnosis of Prune-Belly syndrome. A urinary tract abnormality was suspected starting 25 weeks of gestation, when a routine ultrasound showed oligohydramnios, increased size urinary bladder, bilateral hydronephrosis and megaureters, thin abdominal wall. Diagnosis: Prenatal suspicion of Prune-Belly syndrome plays a deciding role in renal disease progression. A detailed clinical exam at birth established the diagnosis of Prune-Belly syndrome. Renal ultrasound confirmed bilateral grade III hydronephrosis and megaureters, with empty bladder, suggesting an obstructi...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Correct answer: E. All patients need a full medical history, an examination including a digital rectal examination, simple urinalysis and a means to quantify the symptoms, such as a symptom score or frequency –volume chart. Renal function tests are only needed in initial management if there are ‘red flags’ such as a clinical suspicion of renal impairment, for example on patients with nocturnal enuresis, a palpable bladder, hydronephrosis, recurrent urinary tract infections or renal tract calculi.
Source: Medicine - Category: Internal Medicine Tags: Self-assessment/cpd answers Source Type: research
CONCLUSIONS: The median age at clinical presentation for various subgroups of anomalies indicates delayed referral. We emphasize the need for prompt referral in order to initiate appropriate therapeutic strategies in children with congenital anomalies of kidney and urinary tract. PMID: 31333211 [PubMed - in process]
Source: Indian Pediatrics - Category: Pediatrics Authors: Tags: Indian Pediatr Source Type: research
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