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Urography in the child who wets
Insights
Most children with wetting issues do not need urography. However, this imaging can confirm rare conditions mimicking simple enuresis, like spinal anomalies or duplex collecting systems, guiding diagnosis.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
Background:
- Most children experiencing enuresis (bedwetting) lack anatomical abnormalities.
- Urography is often unnecessary for uncomplicated enuresis.
Purpose of the Study:
- To determine the role of urography in diagnosing underlying causes of enuresis.
- To identify specific clinical clues that warrant urographic investigation.
Main Methods:
- Review of cases where urography was used to investigate enuresis.
- Analysis of imaging findings in relation to clinical presentation.
Main Results:
- Urography is beneficial when clinical signs suggest structural abnormalities.
- Key findings include duplex collecting systems, nonfunctioning kidneys, vaginal reflux, and spinal anomalies.
Conclusions:
- Urography can confirm anatomical causes of wetting in select pediatric cases.
- Targeted urography is essential for diagnosing specific conditions mimicking simple enuresis.
Abstract:
Most children who wet have no underlying structural abnormality and will not benefit from urography. However, several conditions may mimic simple enuresis, and in children with clinical clues that suggest these diagnoses, urography can be confirmatory. The urogram should be conducted so as to exclude an anatomic cause for wetting. This is likely in females in the presence of a duplex collecting system, a nonfunctioning kidney, marked vaginal reflux, or a widened interpublic distance. In the urogram of a child of either sex, a spinal anomaly should be sought.