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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
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Role of positional instillation of contrast cystography in the algorithm for evaluating children with confirmed

Basir U Tareen1, Don Bui, Daniel R McMahon

  • 1Department of Urology, Northeastern Ohio University College of Medicine, Children's Hospital Medical Center of Akron, Akron, Ohio, USA. tareen@medicine.nodak.edu

Urology
|May 16, 2006
PubMed

Insights

Positional instillation of contrast (PIC) cystography effectively detects vesicoureteral reflux (VUR) in children with recurrent urinary tract infections when standard imaging fails. Early diagnosis of VUR prevents potential renal scarring and damage.

Area of Science:

  • Pediatric Nephrology
  • Diagnostic Imaging
  • Urology

Background:

  • Recurrent febrile urinary tract infections (UTIs) in children can lead to renal scarring.
  • Vesicoureteral reflux (VUR) is a common cause of recurrent UTIs and potential kidney damage.
  • Standard imaging modalities like voiding cystourethrography and nuclear cystography may not always detect VUR.

Purpose of the Study:

  • To evaluate the effectiveness of positional instillation of contrast (PIC) cystography in identifying VUR.
  • To assess PIC cystography's utility in pediatric patients with renal scarring and negative standard reflux studies.

Main Methods:

  • A prospective study involving 5 pediatric patients with recurrent febrile UTIs and renal scarring.
  • All patients underwent PIC cystography after previous negative standard reflux imaging.
  • PIC cystography involved instilling contrast in a specific position to aid detection.

Main Results:

  • Positional instillation of contrast (PIC) cystography successfully detected VUR in all 5 patients.
  • Unilateral VUR was identified in 3 patients.
  • Bilateral VUR was diagnosed in 2 patients.

Conclusions:

  • PIC cystography is a valuable tool for diagnosing VUR in children with recurrent febrile UTIs when standard methods are inconclusive.
  • Integrating PIC cystography into diagnostic algorithms can lead to earlier VUR detection.
  • Prompt diagnosis and treatment of VUR can prevent long-term renal morbidity and damage.
Abstract

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