The Value of Voiding Cystoureterography on Patients with Prenatal Hydronephrosis: Is It Essent

Kim, Sung Hoon; Lee, Eun Seock; Park, Jae Shin

Abstract

PURPOSE: VCUG has been performed increasingly in neonates with prenatal hydronephrosis. Here, whether VCUG is essential in neonates with mild to moderate hydronephrosis has been investigated.
MATERIALS AND METHODS
65 neonates with less than Society for Fetal Urology grade II hydronephrosis were reviewed. 28 neonates underwent VCUG and 37 neonates were observed without VCUG. An investigation of renal complications was performed using DMSA renal scan, urine analysis and urine culture for up to 60 months postnatally.
RESULTS
4(14.3%) of the 28 neonates presented VUR and received prophylatic antibiotics. Of these 1 case with G V VUR underwent reimplantation due to poor compliance. All 24 neonates with negative VCUG were followed and none showed any signs of UTI. All 14 neonates evaluated by urine analysis and urine culture had normal results, and all 7 neonates evaluated by DMSA renal scan had normal findings. 34 of the 37 neonates observed without VCUG were followed. All 15 evaluated by urine analysis and urine culture and all 3 evaluated by DMSA presented normal results. None of the other 16 showed any signs of UTI. 3 neonates were followed up by telephone-call and showed no signs of UTI.
CONCLUSIONS
On applying VCUG in neonatal hydronephrosis, VUR was detected in 14.3% of the cases, which was significantly higher than that reported among normal children(approximately 1%). However, those hydronephrosis patients without VCUG showed no signs of UTI. Although the study of VCUG is important, it's application to every patients with prenatal hydronephrosis is controversial. Therefore, it is our belief that VCUG may not be essential in neonatal patients with less than grade II hydronephrosis if proper care and periodic tests are given.