Abstract
MP55-04 DO ALL INFANTS WITH PRENATAL HYDRONEPHROSIS NEED a SCREENING VCUG? ANALYSIS OF THE SOCIETIES FOR PEDIATRIC UROLOGY HYDRONEPHROSIS TASKFORCE
The Journal of urology, Vol.211(5S), p.e917
05/2024
DOI: 10.1097/01.JU.0001008616.01808.0f.04
Abstract
INTRODUCTION AND OBJECTIVE:
Prenatal hydronephrosis (PNH) occurs in 1-2% of pregnancies and may be associated with vesicoureteral reflux (VUR). Controversy exists regarding the utility of a screening voiding cystourethrogram (VCUG) to detect VUR in children with PNH, reflected in the 2017 AUA VUR guidelines. The purpose of this study was to identify findings on postnatal renal bladder ultrasound (RBUS) that are predictive of the presence of VUR in children with PNH.
METHODS:
The Societies for Pediatric Urology Hydronephrosis Taskforce reviewed a multicenter prospectively maintained database to identify children with prenatal hydronephrosis who had a screening VCUG from 2008 to 2023. Inclusion criteria included infants with RBUS performed prior to 12 months of age with a subsequent screening VCUG. Those with a ureterocele, duplicated system, renal cysts or multicystic dysplastic kidneys, or with VCUG obtained after UTI or surgery were excluded. The primary outcome was presence of VUR on screening VCUG. Univariate and multivariate analyses were performed.
RESULTS:
Of 1715 patients in the database, 1002 had a VCUG and 656 (65.5%) met inclusion criteria. The mean age at RBUS was 35 days with a mean duration of 62 days until subsequent screening VCUG. VUR was detected in 114 (17.4%). Hydroureter was significantly associated with the presence of VUR (27.2% vs 12.4%; p<0.001). Infants with VUR had a larger mean ureteral diameter (1.1 vs 0.36 cm; p<0.001), increased renal echogenicity (9.6% vs 3.3%; p=0.003), and bladder wall thickening (6.1% vs 2.4%; p=0.035). Between infants with or without VUR, there was no significant difference in sex (male vs female: 72.8% vs 73.6%; p=0.86), high grade hydronephrosis (51.8% vs 45.9%; p=0.26), or bilateral hydronephrosis (49.1% vs 48%; p=0.82). On multivariate analysis, hydroureter (OR=2.4, 95% CI [1.4, 3.9]; p=0.001) and increased renal echogenicity (OR=2.3, 95% CI [1.0, 5.4], p=0.047) were found to be independent predictors of VUR on screening VCUG.
CONCLUSIONS:
Consistent with AUA VUR guidelines, infants with PNH and hydroureter are at increased risk of VUR and benefit from screening VCUG. Similarly, those with increased renal echogenicity may benefit from screening VCUG. In contrast to guidelines, isolated high grade hydronephrosis was not predictive of VUR. Similarly, bilateral hydronephrosis was not predictive of VUR. These data support the selective use of screening VCUG in children with prenatal hydronephrosis.
Details
- Title: Subtitle
- MP55-04 DO ALL INFANTS WITH PRENATAL HYDRONEPHROSIS NEED a SCREENING VCUG? ANALYSIS OF THE SOCIETIES FOR PEDIATRIC UROLOGY HYDRONEPHROSIS TASKFORCE
- Creators
- Ala'a FarkouhCarol Davis-DaoAnthony HerndonRuby KuangSarah WilliamsonRebecca ZeeKai Wen ChengSikai SongShannon CannonLuis H. BragaElias J. WehbiGina M. LockwoodValre WelchNora G. KernMelissa McGrathAnne DudleyDavid A. ChamberlinAntoine E. KhouryJoshua D. Chamberlin
- Resource Type
- Abstract
- Publication Details
- The Journal of urology, Vol.211(5S), p.e917
- DOI
- 10.1097/01.JU.0001008616.01808.0f.04
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Urology; Stead Family Department of Pediatrics
- Record Identifier
- 9984649056102771
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