PYELO-CYSTOURETHROGRAPHY: METHODOLOGY

PEDIATRICS ◽  
1970 ◽  
Vol 46 (4) ◽  
pp. 553-565
Author(s):  
Charles E. Shopfner
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Intravenous Pyelography ◽  
Intravenous Pyelogram ◽  
Retrograde Pyelography ◽  
Abdominal Masses ◽  
Total Body Opacification ◽  
Total Body ◽  
The Individual ◽  
Lower Urinary

Children who require roentgen evaluation of the urinary tract need examination of the entire tract, which is accomplished with a cystourethrogram and an intravenous pyelogram. Cystourethrography yields a higher incidence of pathology than intravenous pyelography, but the procedures are complementary to each other. Intravenous pyelography, which examines the upper urinary tract, includes a large volume dosage of contrast agent, double injection, fluoroscopy, and multiple films during peak excretion, all applied according to the needs of the individual patient. Cystourethrography evaluates the lower urinary tract and utilizes nonirritating contrast agents, fluoroscopy, and sequential spot-films. Retrograde pyelography is indicated only when the collecting system is not visualized by either the intravenous pyelogram or refluxing cystogram. Fluoroscopy and multiple spotfilms assure accuracy in detection and documentation of pathology. Total body opacification is helpful in evaluating abdominal masses of small infants.

Renal Ultrasound Evaluation of Urinary Tract Infections in Children

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 871-878
Author(s):  
Candice E. Johnson ◽  
Baz P. DeBaz ◽  
Paul A. Shurin ◽  
Rose DeBartolomeo
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Infection ◽  
Upper Urinary Tract ◽  
Patient Acceptance ◽  
Renal Ultrasound ◽  
Intravenous Pyelogram ◽  
Ultrasound Evaluation ◽  
Tract Infections

Ultrasonography of the kidney may replace the intravenous pyelogram as the study of choice in identifying treatable abnormalities in children with urinary tract infection. In a series of 64 consecutive children with urinary tract infection in whom an intravenous pyelogram, renal ultrasound, and voiding cystogram were performed, only one treatable abnormality (calyceal dilation) was identified by intravenous pyelogram, and it was not detected by ultrasound. Eleven children showed vesicoureteral reflux on the cystogram. In an additional 43 children in whom intravenous pyelogram was done only if the ultrasound or cystogram were abnormal, there were five abnormal cystograms. Four treatable abnormalities were identified by ultrasound, and three were confirmed by the intravenous pyelogram. Ultrasound should replace the intravenous pyelogram in children with a normal cystogram because of its accuracy, safety, and high patient acceptance. We have also documented a significant volume increase with acute infection in one or both kidney(s) of those children having upper urinary tract infection. Fifteen of 18 children with upper urinary tract infection had volume increases of 30% on more in at least one kidney; whereas only four of 21 children with lower urinary tract infection had increases of greater than 30% (P < .005). Ultrasound volume measurements provide a new, noninvasive method for identifying the probable site of urinary tract infection.

scholarly journals Comprehension and construct validity of the Visual Prostate Symptom Score by men with obstructive lower urinary tract symptoms in rural Africa

2017 ◽  
Vol 11 (11) ◽  
pp. E405-8 ◽  
Author(s):  
Lynn Stothers ◽  
Andrew Macnab ◽  
Francis Bajunirwe ◽  
Sharif Mutabazi ◽  
Catherine Lobatt
Keyword(s):  
Urinary Tract ◽  
Symptom Score ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Formal Education ◽  
Image Size ◽  
Urinary Tract Symptoms ◽  
Student’S T ◽  
The Individual ◽  
Lower Urinary

Introduction: The Visual Prostate Symptom Score (VPSS) is an image-based interpretation of the International Prostate Symptom Score (IPSS) intended to quantify frequency, nocturia, weak stream, and quality of life (QoL) in a literacy-independent manner.Methods: Ugandan men presenting with lower urinary tract symptoms (LUTS) to a rural clinic completed VPSS and IPSS independently and then with assistance. They verbally interpreted VPSS images, rated question usefulness, and suggested improvements. Responses between word-based and image-based measures were compared (Student’s T, Fisher’s exact, and Spearman’s correlation tests).Results: 132 scores from 33 men (mean age: 61 years, range 28‒93; education: no schooling 20%, grades 1‒4 62%, 5‒7 9%, 8‒12 9%). Correlation between IPSS and VPSS scores was positive (r= 0.70), as it was between the individual irritative, obstructive, and QoL questions. Independent of education, the weak stream image was best recognized. Likert scale measures indicated this was the most useful image, followed by daytime frequency. Nocturia and QoL images were rated as less clear, with explanation required before most understood that QoL facial expression images reflected overall LUTS impact. Improvements suggested included: increased image size for frequency and nocturia pictograms, increased black/white contrast for nocturia, and addition of an image to allow reporting of urgency.Conclusions: In a population with little formal education, there was positive correlation between IPSS and VPSS, with inherent recognition best for weak stream and worst for QoL images. Increased image clarity and an additional image for urgency will enhance the global utility of the VPSS for men to report symptoms of LUTS.

Obstructive urinary disorders

2021 ◽  
pp. 677-682
Author(s):  
Noah E. Canvasser ◽  
Jennifer G. Rothschild ◽  
Frederick J. Meyers ◽  
Christopher P. Evans
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Foley Catheter ◽  
Upper Urinary Tract ◽  
Advanced Malignancy ◽  
Lower Urinary Tract Obstruction ◽  
Palliative Care Setting ◽  
Common Causes ◽  
Lower Urinary

Both upper and lower urinary tract obstruction are prevalent in the palliative care setting. Although sometimes related to urological conditions, non-urological aetiologies are also seen. Common causes of lower urinary tract obstruction include benign prostatic hyperplasia in men, an underlying neurological condition, and advanced pelvic malignancy. In the acute setting, bladder decompression with a Foley catheter is the easiest and fastest way to resolve the problem. Common causes of upper urinary tract obstruction include nephrolithiasis and advanced malignancy. This chapter will address the evaluation and management of these common clinical issues.

Neurogenic lower urinary tract dysfunction in the early disease phase of paediatric multiple sclerosis

2016 ◽  
Vol 22 (11) ◽  
pp. 1490-1494 ◽  
Author(s):  
Jeroen R Scheepe ◽  
Yu Yi M Wong ◽  
E Daniëlle van Pelt ◽  
Immy A Ketelslegers ◽  
Coriene E Catsman-Berrevoets ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Upper Urinary Tract ◽  
Lower Urinary Tract Dysfunction ◽  
Early Disease ◽  
High Prevalence ◽  
Potential Damage ◽  
Urinary Problems ◽  
Lower Urinary

Neurogenic lower urinary tract dysfunction (LUTD) in multiple sclerosis (MS) is highly prevalent in adults, but has not previously been described in paediatric MS. A total of 24 consecutive children with newly diagnosed MS were prospectively assessed for bladder and bowel problems early after diagnosis. Five of 24 children (21%) showed LUTD during assessment. One of these patients did not report voiding complaints. This high prevalence of LUTD indicates that all recently diagnosed patients with paediatric MS should be evaluated early in their disease and treated for urinary problems in order to prevent potential damage to the upper urinary tract.

The investigation of haematuria

2017 ◽  
Author(s):  
Richard J Bryant ◽  
James W Catto
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Smoking Status ◽  
Upper Urinary Tract ◽  
Radiological Evaluation ◽  
Patient Factors ◽  
Younger Patients ◽  
Underlying Malignancy ◽  
And Gender ◽  
Lower Urinary

Haematuria is the presence of blood within the urine and is best defined as visible or non-visible, and symptomatic or non-symptomatic. Non-visible haematuria may be further classified as microscopic or dipstick, depending on the investigation used to detect it. Around 40% of patients presenting with visible haematuria will be found to have a significant underlying cause, and around 20% of patients will be found to have an underlying urological malignancy. Many younger patients will be found to have an underlying nephrological disease. The risk of significant underlying malignancy increases with the extent of haematuria (visible versus non-visible), the absence of symptoms and various patient factors (such as rising age, smoking status, and gender). As such, haematuria is an important urological symptom that requires investigation. These investigations should include clinical assessment, urinalysis, lower urinary tract endoscopy, and upper urinary tract radiological evaluation.

MR urography versus retrograde pyelography/ureteroscopy for the exclusion of upper urinary tract malignancy

2010 ◽  
Vol 65 (3) ◽  
pp. 185-192 ◽  
Author(s):  
K.S. Lee ◽  
E. Zeikus ◽  
W.C. DeWolf ◽  
N.M. Rofsky ◽  
I. Pedrosa
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Mr Urography ◽  
Retrograde Pyelography

URETEROCELE IN INFANCY AND CHILDHOOD

PEDIATRICS ◽  
1950 ◽  
Vol 5 (1) ◽  
pp. 68-77
Author(s):  
ROBERT E. GROSS ◽  
H. WILLIAM CLATWORTHY
Keyword(s):  
Urinary Tract ◽  
Urinary Infection ◽  
Bladder Wall ◽  
Upper Urinary Tract ◽  
Conclusive Evidence ◽  
Urinary Flow ◽  
Intravenous Pyelography ◽  
Small Children ◽  
Valuable Adjunct ◽  
Infancy And Childhood

Ureteroceles are abnormalities which result from congenital stenosis of a uretero-vesical junction. That portion of the ureter which obliquely traverses the bladder wall becomes ballooned out so that it projects into the lumen of the bladder. This bulging mass in the bladder may be one to several centimeters in diameter. The lesions are more common in females. The outstanding symptoms are referable to pyuria, which appears in most cases. There may be abdominal or flank pain from the ureteric obstruction. In some patients the ureterocele may lodge in the bladder outlet and block the urinary flow from the entire urinary tract, in this way giving rise to damage in both kidneys. In rare instances a ureterocele may prolapse through the urethra of the female. Ureteroceles are apt to give rise to symptoms in infancy or childhood, but in some cases they are not manifest until later years. Intravenous pyelography and cystography will often give conclusive evidence of the presence of the abnormality, but in some patients cystoscopy will be necessary to establish the diagnosis. Ureteroceles are not difficult to treat. They should never be excised, because such surgical attack is apt to destroy the uretero-vesical valve and permit reflux of urine from the bladder to the upper urinary tract, a complication which results in increasing hydronephrosis and pyelonephritis. A ureterocele mass will collapse by merely incising its dome in a longitudinal manner for a distance of 2 to 4 mm. This effectively relieves the ureteral obstruction and is the most important step in the therapy of any existing urinary infection. Chemotherapy is a valuable adjunct in the treatment of pyuria, but will have permanent benefit only if the mechanical obstruction has been completely eradicated. In babies and small children it is preferable to avoid incision of a ureterocele by cystoscopic instrumentation; it is safer to open the bladder and incise the structure under direct vision. The results of this latter type of therapy are extremely gratifying and in most instances such conservative measures will permit saving of the kidney on the affected side.

scholarly journals Role of Uroflowmetry in Children with Ano-Rectal Malformation in Anticipating Upper Urinary Tract Damage

2017 ◽  
Vol 53 (02) ◽  
pp. 090-096
Author(s):  
Rahul Saxena ◽  
Arvind Sinha ◽  
Manish Pathak ◽  
Avinash S Jadhav ◽  
Ankur Bansal
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Upper Urinary Tract ◽  
Lower Urinary Tract Dysfunction ◽  
Asymptomatic Children ◽  
Determine Role ◽  
Urinary Tract Symptoms ◽  
Tract Damage ◽  
Lower Urinary

ABSTRACT Background: The lower urinary tract dysfunction (LUTD) has high incidence in children with anorectal malformation (ARM) which if left untreated leads to upper tract damage. Aim: To determine role of uroflowmetry in early diagnosis of LUTD in children with ARM. Methods: This prospective study included twenty consecutive patients of ARM and every patient underwent uroflowmetry at-least 6 weeks after definitive procedure. Results: The mean age of patients was 3.015±0.86 years. Of the twenty patients, there were 12 (60%) males and 8 (40%) females; 11 (55%) were high ARM, 4 (20%) were intermediate and 5(25%) were low ARM. Lower urinary tract symptoms (LUTS) was present in 8/20 (40%) patients but uroflowmetric abnormalities were present in 11/20 (55%) patients. Forty five percent (5/11) patients with abnormal uroflowmetry were asymptomatic and 25% (2/8) symptomatic patients had normal uroflowmetry. The incidence of uroflowmetric abnormalities was significantly higher in patients with spinal anomalies (p=0.03; χ2=4.1) and those with high ARM (p=0.004; χ2=8.1). Conclusion: Uroflowmetry is a noninvasive method that may help in early detection of neurovesical dysfunction in asymptomatic children and subsequent cystometric analysis in patients with uroflowmetric abnormalities can be done for early definitive diagnosis and prevention of upper urinary tract damage.

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