• Childhood Kidney Diseases
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• v.28 no.1
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• pp.1-7
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• 2024

Antenatally diagnosed urinary tract dilatation (UTD), previously referred to as antenatal hydronephrosis, is the most commonly detected abnormality by prenatal ultrasonography. Several grading systems have been developed for the classification of antenatal UTD using prenatal and postnatal ultrasonography. UTD comprises a wide variety of congenital abnormalities of the kidney and urinary tract ranging from transient UTD to more significant abnormalities such as vesicoureteral reflux, ureteropelvic junction obstruction, ureterocele, ureterovesical junction obstruction, posterior urethral valves, and non-refluxing megaureter. Optimizing the evaluation of antenatally detected UTD is essential to recognize children with important disorders while avoiding excessive investigations. Conservative approach with close follow-up is increasingly accepted as an appropriate treatment option for patients with asymptomatic vesicoureteral reflux and ureteropelvic junction obstruction in recent years. However, predicting permanent kidney damage in an unselected group of children with antenatal UTD is still challenging. The management and follow-up of children with UTD should be individualized based on recommendations from a pediatric nephrologist, a pediatric urologist, or both. Future research directed at predicting long-term outcomes of children diagnosed with UTD from mild findings to severe disease is needed to refine management for those at higher risk of kidney disease progression.

• Korean Journal of Radiology
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• v.1 no.3
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• pp.152-158
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• 2000

Objective: The purpose of this study was to compare the effectiveness of MR urography (MRU) with that of ultrasonography (US) in the evaluation of urinary tract when this failed to opacify during excretory urography (EXU). Materials and Methods: Twelve urinary tracts in 11 patients were studied. In each case, during EXU, the urinary system failed to opacify within one hour of the injection of contrast media, and US revealed dilatation of the pelvocalyceal system. Patients underwent MRU, using a HASTE sequence with the breath-hold technique; multi-slice acquisition was then performed, and the images were reconstructed using maximal intensity projection. Each set of images was evaluated by three radiologists to determine the presence, level, and cause of urinary tract obstruction. Results: Obstruction was present in all twelve cases, and in all of these, MRU accurately demonstrated its level. In this respect, however, US was successful in only ten. The cause of obstruction was determined by MRU in eight cases, but by US in only six. In all of these six, MRU also successfully demonstrated the cause. Conclusion: MRU is an effective modality for evaluation of the urinary tract when this fails to opacify during EXU, and appears to be superior to US in demonstrating the level and cause of obstruction.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.106-111
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• 2003

We experienced a 4-month-old boy presenting with fever and painful scrotal swelling. Diagnostic work-up showed the presence of urinary tract infection and concurrent acute epididymitis. On the voiding cystourethrography, vesicoureteral reflux and urinary reflux through the ejaculatory duct and the seminal vesicle were detected without obvious urethral obstruction. In general, urinary reflux into the seminal vesicle can take place with obstructive lesions of the urethra and may cause epididymitis in infants. We report a case of urinary reflux without urethral obstruction with a brief review of related literatures.

• Journal of Veterinary Clinics
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• v.38 no.2
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• pp.63-68
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• 2021

Urethral obstruction is a life-threatening feline lower urinary tract disease (FLUTD). The rate of recurring urethral obstruction was 14.8-58.1% after the first occurrence. Ultrasonographic findings associated with reobstruction had been rarely reported although ultrasonography was a valuable technique for diagnosing urinary bladder calculi and distinguishing different FLUTD causes. This retrospective study aims to describe the ultrasonographic findings, urinalysis, and serum chemistry profile in cats with FLUTD and determine the associations of reobstruction with ultrasonographic findings, urinalysis, and serum chemistry profile. The present study included 141 cats that were followed up for more than 1 year. The ultrasonographic criteria included the presence of cystolithiasis, urine echogenicity, sediment, suspended linear strand, pericystic effusion, hyperechoic pericystic fat, ureteral dilation, pyelectasia, and perirenal effusion. The urinalysis criteria included hematuria, urine-specific gravity, pH, sediment, and proteinuria. The most common ultrasonographic findings in cats with FLUTD were echogenic urine and sediment. However, this study did not find an association between reobstruction and ultrasonographic findings, urinalysis, and serum chemistry profiles. Thus, an ultrasonographic examination may be insufficient to predict the risk of reobstruction although it is a useful modality for diagnosing FLUTD and making treatment direction.

• Journal of Biomedical Engineering Research
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• v.31 no.4
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• pp.302-309
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• 2010

The present study proposed a method of measuring uroflow and urophonography at the same time for more accurate diagnosis in case uroflow looks normal due to compensatory function hypertrophy in the expression of early obstruction. In case of early obstruction, there happens turbulent uroflow by the obstruction even if the uroflow looks normal and thus obstruction can be detected by measuring and analyzing signal caused by turbulent flow. We implemented a system that can measure both uroflow and urophonography, and evaluated its performance. In the experiment, we observed changes in uroflow and urophonography according to artificial pressure and the degree of obstruction, and confirmed that it is possible to determine the effect of compensatory function hypertrophy by analyzing urophonographyic parameter under the same uroflow. The results of our experiment show that the effect of compensatory function hypertrophy in the early-stage obstruction of lower urinary tract, which is not detectible with uroflowmetry alone, can be assessed through urophonographic analysis.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.181-185
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• 2012

An 11-year-old, intact female Shihtzu showing anuria was diagnosed as a urethral leiomyoma. The tumor occupied and obstructed the urethral lumen. In this report, the urethral tumor and secondary obstruction could be diagnosed via ultrasonography and contrast study such as excretory urography and voiding urethrography. Ultrasonography revealed a hypoechoic, demarcated urethral mass in proximal urethra. Contrast study confirmed the urethral obstruction and ruled out the expansion of the tumor into the urinary bladder. The clinical signs of the dog were completely resolved after removing the urethral mass and urethral anastomosis. Leiomyoma is a benign smooth muscle tumor, and rarely reported in lower urinary tract.

• Neonatal Medicine
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• v.18 no.2
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• pp.379-382
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• 2011

Spontaneous intraperitoneal extravasation of urine is rare. Perirenal urinoma may develop when obstruction to urinary flow creates sufficient back pressure to produce extravasation of urine. Urinary ascites most commonly indicate a disruption to the integrity of the urinary tract. We report a case of urinary ascites with urinoma resulting from an ureteropelvic junction obstruction in a neonate.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.67-72
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• 1997

Purpose : Congenital urinary tract anomaly is the most common anomaly in the childhood and progress to chronic renal failure and growth retardation. Therefore, early diagnosis arid treatment of urinary tract anomaly are important. Method : We reviewed medical records of 124 patients who had urinary tract anomalies on radiologic studies from Jan. 1986 to Dec. 1996. We analyzed demography and clinical characteristics of urinary tract anomalies. Results : 1) The age distributions were as follows ; 61 cases of 124 patients (49%) were under 1 year, 11 cases (8.8%) from 1 to 3 years, 20 cases (16%) from 4 to 6 years, 10 cases (8%) from 7 to 9 years, 9 cases (7.2%) from 10 to 12 years, 10 cases (8%) from 13 to 15 years, and 3 cases (2.4%) from 16 to 18 years. 2) Chief complaints in patients with urinary tract anomalies were fever, flank pain, prenatally diagnosed hydronephrosis, abdominal mass, dysuria and hematuria. 3) Of 124 patients, 68 cases(54.8%) were combined with urinary tract infection, and main causative organism was E.coli, and the most frequently associated anomaly was vesicoureteral reflux. 4) Most of the urinary tract anomalies were VUR, UPJ obstruction, congenital hydronephrosis and double ureter in order of sequence. 5) Whereas the frequency of simple urinary tract anomaly was 87.9%, that of complex anomaly was 12%. 6) Operative corrections were needed in 47 cases and 7 cases were progressed to renal insufficiency. Conclusion : We emphasize that early detection of urinary tract anomaly, appropriate treatment and regular follow-up are needed.

• Childhood Kidney Diseases
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• v.28 no.2
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• pp.59-65
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• 2024

Hydronephrosis, characterized by dilation of the renal pelvis and calyces due to urine flow obstruction, poses a significant clinical challenge. Although often asymptomatic and capable of spontaneous resolution, surgical intervention is necessary for specific scenarios such as febrile urinary tract infections, deteriorating hydronephrosis, or declining renal function. The efficacy of continuous antibiotic prophylaxis in preventing urinary tract infections remains controversial. Yet, it may benefit high-risk patients, emphasizing the importance of individualized patient selection, as surgical treatment methods for patients with hydronephrosis have become less invasive than in previous decades. However, long-term follow-up outcomes are lacking, necessitating further clarification. This review presents an overview of the etiology, natural progression, and modern management of hydronephrosis, encompassing advancements in minimally invasive procedures.

• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.202-205
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• 2003

A 10 days old male infant with congenital megacalyces and megaureter, diagnosed by prenatal ultrasonographic screening, underwent Tc-99m DTPA renal scan for evaluation of urinary tract patency, Tc-99m DMSA scan for evaluation of renal cortical damage. He also underwent intravenous urography(IVU) and renal ultrasonography. Tc-99m DTPA renal scan demonstrates intense tracer accumulation in enlarged both renal pelvocalyses and ureters, which rapidly washout without diuretics administration. Tc-99m DMSA renal cortical scan shows no remarkable photon defect in both renal cortices and visible tracer uptake in both megaureter areas. Ultasonographic and IVU studios show enlarged both renal calyses and bullously dilated ureters, but no dilatation in renal pelvis. Follow up Tc-99m DTPA renal scan, peformed at one year later, also reveals intense tracer accumulation in enlarged both urinary tracts which rapidly washout without diuretics, and shows no significant change compare to the previous Tc-99m DTPA renal scan. Urinary tract obstruction and renal cortical damage can be easily evaluated with Tc-99m DTPA and Tc-99m DMSA scans in patiens with megacalyces and megaureter.