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Obstruction in the refluxing urinary tract--a common phenomenon.
1Department of Radiology, Royal Children's Hospital, Parkville, Melbourne, Australia.
Clinical Radiology
|May 1, 1989
Summary
Urinary tract obstruction and primary reflux coexist more often than previously thought, affecting about 1 in 20 patients with reflux. Suspect obstruction in reflux patients with dilated ureters; a simple drainage film can help rule it out.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
- Nephrology
Background:
- Urinary tract dilatation can stem from vesicoureteric reflux, obstruction, or primary causes.
- These conditions can occur independently or concurrently in patients.
- Understanding the overlap is crucial for accurate diagnosis and management.
Purpose of the Study:
- To determine the incidence and characteristics of coexisting urinary tract obstruction and primary reflux.
- To highlight the clinical significance of this combined condition.
- To emphasize diagnostic approaches for differentiating causes of urinary tract dilatation.
Main Methods:
- Retrospective review of patient cases with urinary tract dilatation.
- Analysis of factors including vesicoureteric reflux and urinary tract obstruction.
- Evaluation of diagnostic imaging, specifically micturating cystourethrogram (MCU) with drainage films.
Main Results:
- The coexistence of urinary tract obstruction and primary reflux is more common than previously reported.
- Approximately 1 in 20 patients with reflux also exhibit obstruction.
- Dilated or tortuous ureters in reflux patients warrant suspicion for obstruction.
Conclusions:
- Coexisting reflux and obstruction is a significant clinical entity.
- A high index of suspicion for obstruction is needed in reflux patients with ureteral anomalies.
- A post-micturition drainage film following MCU is vital for ruling out obstruction.