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Related Experiment Videos

Does every patient with prenatal hydronephrosis need voiding cystourethrography?

E B Yerkes1, M C Adams, J C Pope

  • 1Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

The Journal of Urology
|August 24, 1999
PubMed
Summary
This summary is machine-generated.

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Careful observation may avoid voiding cystourethrography in infants with mild (less than Society for Fetal Urology grade II) postnatal hydronephrosis. Most infants observed without this test showed no adverse renal events, suggesting it

Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging
  • Renal Medicine

Background:

  • Prenatal ultrasound identifies urinary tract abnormalities requiring follow-up.
  • Early identification of fetal hydronephrosis necessitates postnatal evaluation.
  • Current guidelines recommend ultrasound for all infants with prenatal hydronephrosis.

Observation:

  • 175 infants with prenatal hydronephrosis were evaluated over 5 years.
  • 44 infants with less than Society for Fetal Urology grade II hydronephrosis underwent voiding cystourethrography.
  • 16 infants with less than grade II hydronephrosis were observed without voiding cystourethrography.

Findings:

  • 15% of infants with less than grade II hydronephrosis had positive voiding cystourethrography results.

Related Experiment Videos

  • 3 infants had grade III or higher vesicoureteral reflux; 1 required surgery.
  • None of the 16 observed infants experienced adverse renal events during follow-up (6 months to 4.5 years).

    • Implications:

    • Voiding cystourethrography may not be mandatory for all infants with less than grade II postnatal hydronephrosis.
    • Careful counseling and monitoring can allow observation in select cases.
    • Ultrasound findings should guide further urological evaluation, potentially avoiding unnecessary procedures.