Çocuk Dergisi

1308-8491

Istanbul University

10.26650/jchild.2022.1099219

Paediatrics

Çocuk Sağlığı ve Hastalıkları

Can Impaired Distal Ureteral Contraction Detected by Urinary Ultrasonography Indicate Presence of VUR?

Üriner Ultrasonografide Tespit Edilen Bozulmuş Distal Üreter Kontraksiyonu Vezikoüreteral Reflüyü Gösterebilir mi?

https://orcid.org/0000-0002-9412-6733

Keçeli

Avni Merter

nkara Bilkent City Hospital, Department of Pediatric Radiology, Ankara, Turkiye

https://orcid.org/0000-0002-2828-7942

Dönmez

Muhammet İrfan

Ankara Bilkent City Hospital, Department of Pediatric Radiology, Ankara, Turkiye

12 29 2022

22 3 208 213 04 06 2022 07 29 2022

2000

Journal of Child

Objective: The aim of this study was to determine if impaired distal ureteral contraction detected by urinary ultrasonography (US) could predict presence of vesicoureteral reflux (VUR). Materials and Methods: A Retrospective analysis of patients’ files between November 2016 and September 2020 was performed. A total of 248 children with demonstrated VUR on voiding cystourethrogram (VCUG) and who underwent urinary US within one week of the VCUG examination were included in the study. The degree of hydronephrosis was classified as per Society for Fetal Urology grading system and grading of VUR was done by the International Reflux Study Group grading system. The impaired distal ureteral contraction was defined as the reduced movement of the distal ureter as well as the deficiency of urine discharge into the bladder. Results: There was a significant correlation between the grade of VUR and the grade of hydronephrosis (p=0.0028). Also, the presence of distal ureteral dilation was related to increasing grades of VUR (p=0.001). The impaired distal ureteral contraction was present only in children with dilating VUR (grades III IV V) while its relationship between VUR grade was significantly high for grades IV and V VUR (p=0.001). Conclusion: In children, the impaired distal ureter contraction as well as the increase of grades of hydronephrosis, and the presence of distal ureteral dilation may aid decision-making in terms of requesting VCUG to detect dilating VUR.

Amaç: Bu çalışmanın amacı, üriner ultrasonografi (US) ile saptanan bozulmuş distal üreter kontraksiyonunun vezikoüreteral reflü (VUR) varlığını tahmin edip edemeyeceğini belirlemekti. Gereç ve Yöntem: Kasım 2016 ile Eylül 2020 arasındaki hasta dosyalarının retrospektif analizi yapıldı. İşeme sistoüretrogramında (VCUG) VUR gösterilen ve VCUG muayenesinden sonraki bir hafta içinde üriner US yapılan toplam 248 çocuk çalışmaya dahil edildi. Hidronefroz derecesi, Society for Fetal Urology derecelendirme sistemine göre sınıflandırıldı ve VUR derecelendirmesi, International Reflux Study Group derecelendirme sistemine göre yapıldı. Bozulmuş distal üreter kontraksiyonu, distal üreterin hareketinin azalması ve mesaneye idrar çıkışının olmaması olarak tanımlandı. Bulgular: VUR derecesi ile hidronefroz derecesi arasında anlamlı bir ilişki vardı (p=0,0028). Ayrıca distal üreter dilatasyonu varlığı artan VUR derecesi ile ilişkiliydi (p=0,001). Bozulmuş distal üreter kontraksiyonu sadece dilate VUR’lu (derece III-V) çocuklarda mevcutken, derece IV ve VUR için VUR derecesi arasındaki ilişki anlamlı olarak yüksekti (p=0,001). Sonuç: Çocuklarda bozulmuş distal üreter kontraksiyonu, artan hidronefroz dereceleri ve distal üreter dilatasyonunun varlığı, dilatasyon yapan VUR’u saptamak için VCUG talep etme konusunda karar vermeye yardımcı olabilir.

VUR VCUG ultrasonography children radiation exposure

Vezikoüreteral reflü ultrasonografi üreteral kontraksiyon

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