MP55-04 DO ALL INFANTS WITH PRENATAL HYDRONEPHROSIS NEED a SCREENING VCUG? ANALYSIS OF THE SOCIETIES FOR PEDIATRIC UROLOGY HYDRONEPHROSIS TASKFORCE

You have accessJournal of UrologyPediatrics IV (MP55)1 May 2024MP55-04 DO ALL INFANTS WITH PRENATAL HYDRONEPHROSIS NEED a SCREENING VCUG? ANALYSIS OF THE SOCIETIES FOR PEDIATRIC UROLOGY HYDRONEPHROSIS TASKFORCE Ala'a Farkouh, Carol Davis-Dao, Anthony Herndon, Ruby Kuang, Sarah Williamson, Rebecca Zee, Kai Wen Cheng, Sikai Song, Shannon Cannon, Luis H. Braga, Elias J. Wehbi, Gina M. Lockwood, Valre Welch, Nora G. Kern, Melissa McGrath, Anne Dudley, David A. Chamberlin, Antoine E. Khoury, and Joshua D. Chamberlin Ala'a FarkouhAla'a Farkouh , Carol Davis-DaoCarol Davis-Dao , Anthony HerndonAnthony Herndon , Ruby KuangRuby Kuang , Sarah WilliamsonSarah Williamson , Rebecca ZeeRebecca Zee , Kai Wen ChengKai Wen Cheng , Sikai SongSikai Song , Shannon CannonShannon Cannon , Luis H. BragaLuis H. Braga , Elias J. WehbiElias J. Wehbi , Gina M. LockwoodGina M. Lockwood , Valre WelchValre Welch , Nora G. KernNora G. Kern , Melissa McGrathMelissa McGrath , Anne DudleyAnne Dudley , David A. ChamberlinDavid A. Chamberlin , Antoine E. KhouryAntoine E. Khoury , and Joshua D. ChamberlinJoshua D. Chamberlin View All Author Informationhttps://doi.org/10.1097/01.JU.0001008616.01808.0f.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail 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. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e917 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ala'a Farkouh More articles by this author Carol Davis-Dao More articles by this author Anthony Herndon More articles by this author Ruby Kuang More articles by this author Sarah Williamson More articles by this author Rebecca Zee More articles by this author Kai Wen Cheng More articles by this author Sikai Song More articles by this author Shannon Cannon More articles by this author Luis H. Braga More articles by this author Elias J. Wehbi More articles by this author Gina M. Lockwood More articles by this author Valre Welch More articles by this author Nora G. Kern More articles by this author Melissa McGrath More articles by this author Anne Dudley More articles by this author David A. Chamberlin More articles by this author Antoine E. Khoury More articles by this author Joshua D. Chamberlin More articles by this author Expand All Advertisement PDF downloadLoading ...