Validation of “urinary tract dilation” classification system: Correlation between fetal hydronephrosis and postnatal urological abnormalities

Aim to illuminate the correlation between fetal hydronephrosis and postnatal urological abnormalities by a new classification system—“urinary tract dilation (UTD)” grade. Of 659 pregnancies screened by ultrasound, 34 cases were found with isolated fetal hydronephrosis, and enrolled in our study from 2017 to 2019. These 34 infants had been prospectively followed up to 6 months after birth by 3 times of urinary tract ultrasound. Hydronephrosis was graded in accordance with the UTD classification system. Among 34 infants with isolated fetal hydronephrosis. Twenty-four (70.6%) were classified as UTD A1 grade (mild hydronephrosis), and the other 10 (29.4%) were UTD A2–3 grade (moderate to severe hydronephrosis) by antenatal evaluation. After birth, all of the 24 infants (70.6%) with UTD A1 grade had normal ultrasonic findings of urinary tract; while the other 10 cases with UTD A2–3 grade had persistent abnormalities of urinary tract by postnatal assessment, sorted as UTD P1 grade (mild hydronephrosis) in 6 cases (17.6%), UTD P2 grade (moderate hydronephrosis) in 2 cases (5.9%) and UTD P3 grade (severe hydronephrosis) in 2 cases (5.9%). The most common postnatal urological abnormality of isolated fetal hydronephrosis was vesicoureteral reflux. During the follow-up period, 7 infants (20.6%) had urinary tract infection episodes and very few obtained positive cultures of the urine. Only 2 infants (5.9%) with the diagnosis of ureterovesical junction obst...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

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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
​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
Conclusions: First UTI in a group of Thai children occurred in approximately equal proportion in boys and girls but boys were younger at diagnosis. Kidney and urinary tract anomalies were detected in half of the children.Urol Int
Source: Urologia Internationalis - Category: Urology & Nephrology Source Type: research
This study aimed to assess predictors for grade 3 –5 vesicoureteral reflux (VUR) in infants ≤ 2 months of age admitted for first urinary tract infection (UTI).MethodsRetrospective cohort study of 195 infants ≤ 2 months admitted to a pediatric ward for first UTI between 2006 and 2017. Clinical, laboratory, and imaging data were collected from electronic medical charts. We examined associations between grade 3–5 VUR and different patient characteristics.ResultsTwenty infants (10%) were diagnosed with grade 3 –5 VUR; all had fever. Infants with grade 3–5 VUR had higher blo...
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionsOur experience suggested that RALP in HSK is safe, feasible and with good medium-term outcomes in expert hands. An accurate pre-operative planning associated with a standardized technique is key points to achieve good surgical and functional outcomes in these challenging cases. The da Vinci robot technology offers the advantages of MIS procedures and overcomes the technical challenges of laparoscopic approach.
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
Conclusions: Pain is the predominant presenting feature in these patients who present at an older age. Despite older age at presentation, these patients have well-preserved renal function and mild hydronephrosis. No specific RDS or ultrasound findings can predict the presence of a CLPV. As the incidence of CLPV is <10% and management is essentially same as PUJO with intrinsic obstruction, preoperative Doppler or MRA are extraneous.
Source: Journal of Indian Association of Pediatric Surgeons - Category: Surgery Authors: Source Type: research
Conclusion Urinary drainage using small catheters or nasogastric tube in the early days of infancy followed by valve ablation is the best treatment modality in PUV.
Source: Annals of Pediatric Surgery - Category: Surgery Tags: Original Articles Source Type: research
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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