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Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
ISSN: 1018-4406
EISSN: 2008-2150
Vol. 19, No. 4, 2009, pp. 347-353
Bioline Code: pe09040
Full paper language: English
Document type: Research Article
Document available free of charge

Iranian Journal of Pediatrics, Vol. 19, No. 4, 2009, pp. 347-353

 en Vesicoureteral Reflux in Neonates with Hydronephrosis; Role of Imaging Tools
Mohammadjafari, Hamid; Alam, Alireza; Kosarian, Mehrnoosh; Mousavi, Seyed-Abdollah & Kosarian, Shahab

Abstract

Objective: Neonatal Hydronephrosis is a common abnormality diagnosed ante- or postnatally. The aim of this study was to determine the prevalence and severity of vesicoureteral reflux (VUR) in neonates with antenatal or postnatal hydronephrosis and the value of ultrasono­graphy as a noninvasive tool for VUR prediction.
Methods: In a prospective study, 202 infants with neonatal hydronephrosis were studied. Two successive renal ultrasound examinations were performed at 1 and 4-6 weeks after birth in neonates with antenatal hydronephrosis or immediately after presentation. Voiding cysto­urethrography (VCUG) was performed in all infants.
Findings: The incidence of VUR was 29.7%, of which 17.8% had severe (grade IV-V) reflux. 27% of 133 neonates with unilateral and 34.8% of 69 cases with bilateral hydronephrosis had VUR. Although a significant association was observed between severity of hydronephrosis and VUR, 5.9% of normal appearing and 7.8% of grade 1 hydronephrotic neonates had high-grade reflux.
Conclusion: VUR was observed significantly in hydronephrotic neonates. A normal or mildly hydronephrotic urinary tract on ultrasound scan cannot exclude presence of severe VUR. We recommend performing VCUG in all hydronephrotic newborns.

Keywords
Vesicoureteral reflux; Hydronephrosis; Voiding cystoureterography; Ultrasound

 
© © 2009 by Center of Excellence for Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences,All rights reserved.
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