Is voiding cystourethrography necessary for evaluating unilateral ectopic pelvic kidney?

Area of Science:

• Pediatric Nephrology
• Urology
• Diagnostic Imaging

Background:

• Unilateral ectopic pelvic kidney (UEPK) is a congenital anomaly requiring careful evaluation.
• The necessity of voiding cystourethrography (VCUG) for identifying vesicoureteral reflux (VUR) in UEPK cases remains debated.
• Minimizing radiation exposure and infection risk in pediatric patients is a clinical priority.

Purpose of the Study:

• To determine the diagnostic yield of VCUG in evaluating UEPK for VUR.
• To assess the incidence of VUR and hydronephrosis in patients with UEPK.
• To provide evidence-based recommendations on the routine use of VCUG in UEPK management.

Main Methods:

• Retrospective review of 72 patients with UEPK diagnosed between 2011 and 2017.
• Exclusion of complex ectopia cases (crossed, fused, bilateral).
• Diagnosis confirmed by ultrasonography and dimercaptosuccinic acid scintigraphy; VCUG data analyzed for VUR presence.

Main Results:

• Only 1 out of 42 patients (2.4%) who underwent VCUG showed VUR.
• Hydronephrosis was infrequent (5.6%), and renal scars were noted in 15% of patients.
• UEPKs contributed a mean of 37.9% to total renal function.

Conclusions:

• Hydronephrosis and VUR are uncommon findings in patients with UEPK.
• Routine VCUG is not recommended for UEPK evaluation due to low VUR incidence.
• Avoiding routine VCUG reduces radiation exposure and UTI risk in children with UEPK.