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Diagnosis of vesicoureteral reflux
Medical expert of the article
Last reviewed: 23.04.2024
The increase in the number of detected patients with vesicoureteral reflux has recently been associated with a wide introduction of new methods for diagnosis of vesicoureteral reflux: antenatal ultrasound, complex urodynamic examination, profilometry of vesicoureteral anastomosis, radioisotope methods for assessing kidney function and endoscopy.
Stage diagnostics of vesicoureteral reflux allows objectively, from common pathogenetic positions, to determine indications for operative and conservative treatment and to evaluate its results. Examination of a patient with vesicoureteral reflux (or with suspected vesicoureteral reflux) should include the following steps.
Outpatient and polyclinic:
- clinical and laboratory examination;
- Ultrasound;
- radioisotope renography;
- UFM;
- excretory urography;
- cystourethrography.
In children under 7 years old, the last two studies must be performed in a hospital; radioisotope renography is replaced by dynamic nephroscintigraphy.
Clinical:
- clinical and laboratory research;
- Ultrasound;
- dynamic or static nephroscintigraphy (according to indications);
- excretory (infusion) urography or MSCT;
- Mikrotsionnaya cystourethrography;
- UFM, complex urodynamic examination (retrograde cystometry, urethral canal profilometry) (according to indications);
- cystoscopy, morphometry of urethral mouths, profilometry of vesicoureteral anastomosis (according to indications).
Catamnestic (outpatient):
- clinical and laboratory examination;
- Ultrasound;
- radioisotope renography;
- Mikcionnaya cystourethrography-
- excretory (infusion) urography;
- UFM, retrograde cystometry.
Particular importance in the absence of vesicoureteral reflux according to radiocontrast cystography in patients with suspected intermittent reflux has a so-called gas cystography. Diagnosis of vesicoureteral reflux is to carry out ultrasound of the kidneys before and after filling the bladder with oxygen (through a cystostomy drainage tube or a pre-installed urethral catheter). When intermittent vesicoureteral reflux is determined by the flow of gas into the collecting system of the kidneys (normally the valve is able to prevent retrograde oxygen transfer).
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