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Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
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Vesicoureteric reflux in children.

Kjell Tullus1

  • 1Department of Nephrology, Great Ormond Street Hospital for Children, London, UK.

Lancet (London, England)
|August 29, 2014
PubMed
Summary

Vesicoureteric reflux (VUR), the backward flow of urine to the kidneys, affects many infants. This seminar reviews current management strategies for pediatric VUR, emphasizing updated guidelines and controversial recommendations.

Area of Science:

  • Pediatric Nephrology
  • Urology

Background:

  • Vesicoureteric reflux (VUR) involves urine flowing backward from the bladder to the ureters and kidneys, primarily impacting infants.
  • Severe VUR can lead to ureteral and renal pelvis dilation.
  • Recent studies indicate a higher prevalence of VUR in children (25-40%) than previously believed.

Purpose of the Study:

  • To present data on the management of pediatric vesicoureteric reflux.
  • To offer guidance on navigating current, often controversial, recommendations for VUR management in children.

Main Methods:

  • Review of current literature and clinical data on pediatric vesicoureteric reflux.
  • Analysis of existing guidelines regarding VUR investigation and treatment.

Main Results:

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  • Traditional views on VUR prevalence may be underestimated; current estimates suggest 25-40% of affected children.
  • Guidelines recommend reducing investigations for VUR after febrile urinary tract infections.
  • Prophylactic antibiotics and surgery are advised against for non-severe pediatric VUR cases.

Conclusions:

  • Current management guidelines for pediatric VUR are debated.
  • A critical review of VUR management strategies is necessary for optimal patient care.
  • This seminar aims to provide clarity and suggestions for managing children with VUR.