Distal ureteral diameter measurement objectively predicts vesicoureteral reflux outcome

Christopher S Cooper; Kevin K Birusingh; J Christopher Austin; Matthew J Knudson; Patrick D Brophy

doi:10.1016/j.jpurol.2011.12.011

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Distal ureteral diameter measurement objectively predicts vesicoureteral reflux outcome

Journal article

Open access

Peer reviewed

Distal ureteral diameter measurement objectively predicts vesicoureteral reflux outcome

Christopher S Cooper, Kevin K Birusingh, J Christopher Austin, Matthew J Knudson and Patrick D Brophy

Journal of pediatric urology, Vol.9(1), pp.99-103

02/2013

DOI: 10.1016/j.jpurol.2011.12.011

PMID: 22236467

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Abstract

Vesicoureteral reflux (VUR) grading may be difficult when discrepancies exist between the degree of dilation of the pyelocalyceal system and the ureter. Resolution may be more accurately predicted by the appearance of the distal ureter. We analyzed a novel, objective method of evaluating VUR based on the diameter of the distal ureter. Seventy-nine voiding cystourethrograms were reviewed (18 boys; 61 girls; aged 1 month to 7.5 years). The largest ureteral diameter within the false pelvis was measured and normalized by dividing by the distance from the L1-L3 vertebral body to give the distal ureteral diameter: L1-L3 ratio (UDR). Clinical outcome was defined as spontaneous resolution or surgical correction. A significant association between grade and UDR existed (p < 0.0001). Mean UDR was significantly greater in those who underwent surgical correction (0.34 ± 0.02 vs 0.18 ± 0.02; p < 0.0001). Logistic regression analysis demonstrated a significant association of UDR with outcome controlling for grade (p = 0.001). Grade effect on outcome when controlling for UDR was not significant (p = 0.76). Odds ratio for surgical correction corresponding to a 0.1 increase in UDR equaled 2.25 (95% CI: 1.39, 3.64). UDR provides an objective measurement of VUR and appears more predictive of clinical outcome than grade in this series.

Radiography

Endoscopy

Predictive Value of Tests

Lumbar Vertebrae - diagnostic imaging

Humans

Child, Preschool

Infant

Logistic Models

Male

Treatment Outcome

Vesico-Ureteral Reflux - diagnostic imaging

Ureter - surgery

Vesico-Ureteral Reflux - surgery

Vesico-Ureteral Reflux - pathology

Female

Retrospective Studies

Ureter - diagnostic imaging

Ureter - pathology

Child

Infant, Newborn

Details

Title: Subtitle: Distal ureteral diameter measurement objectively predicts vesicoureteral reflux outcome
Creators: Christopher S Cooper - Division of Pediatric Urology, Dialysis & Transplantation, The University of Iowa, Iowa City, IA 52242-1089, USA. christopher-cooper@uiowa.edu
Kevin K Birusingh
J Christopher Austin
Matthew J Knudson
Patrick D Brophy
Resource Type: Journal article
Publication Details: Journal of pediatric urology, Vol.9(1), pp.99-103
DOI: 10.1016/j.jpurol.2011.12.011
PMID: 22236467
NLM abbreviation: J Pediatr Urol
ISSN: 1477-5131
eISSN: 1873-4898
Publisher: England
Language: English
Date published: 02/2013
Academic Unit: Stead Family Department of Pediatrics; Urology; Medicine Administration
Record Identifier: 9984051789802771

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