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Diagnosis of vesicoureteral reflux
Medical expert of the article
Last reviewed: 06.07.2025
The recent increase in the number of patients diagnosed with vesicoureteral reflux is associated with the widespread introduction of new methods for diagnosing vesicoureteral reflux: antenatal ultrasound, complex urodynamic studies, profilometry of the vesicoureteral junction, radioisotope methods for assessing renal function, and endoscopy.
Staged diagnostics of vesicoureteral reflux allows objectively, from a unified pathogenetic position, to determine indications for surgical and conservative treatment and to evaluate its results. Examination of a patient with vesicoureteral reflux (or with suspected vesicoureteral reflux) should include the following stages.
Outpatient and polyclinic:
- clinical laboratory examination;
- ultrasound;
- radioisotope renography;
- UFM;
- excretory urography;
- micturition cystourethrography.
In children under 7 years of age, the last two studies must be performed in a hospital; radioisotope renography is replaced by dynamic nephroscintigraphy.
Clinical:
- clinical laboratory research;
- ultrasound;
- dynamic or static nephroscintigraphy (as indicated);
- excretory (infusion) urography or MSCT;
- micturition cystourethrography;
- UFM, comprehensive urodynamic study (retrograde cystometry, profilometry of the urethra) (as indicated);
- cystoscopy, morphometry of the urethral orifices, profilometry of the vesicoureteral junction (as indicated).
Follow-up (outpatient):
- clinical laboratory examination;
- ultrasound;
- radioisotope renography;
- micturition cystourethrography-
- excretory (infusion) urography;
- UFM, retrograde cystometry.
Of particular importance in the absence of vesicoureteral reflux according to X-ray contrast cystography in patients with suspected intermittent reflux is the so-called gas cystography. Diagnosis of vesicoureteral reflux involves performing ultrasound of the kidneys before and after filling the bladder with oxygen (through a cystostomy drainage tube or a pre-installed urethral catheter). In intermittent vesicoureteral reflux, gas entry into the renal collecting system is determined (normally the valve is able to prevent retrograde oxygen reflux).
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