Ureteral disorders in children

Abstract

Children with vesicoureteral reflux usually present with a urinary tract infection (UTI), although some cases are diagnosed during the evaluation of prenatally detected hydronephrosis. Approximately 25% of children with a UTI will be found to have reflux. Ultrasound is normal in 75% of children with reflux, and so children with a significant UTI are evaluated with a voiding cystourethrogram (VCUG). Reflux is graded based on the appearance of the VCUG: Grade 1: Reflux into the ureter only Grade 2: Reflux into the kidney with no distortion of the collecting system Grade 3: Reflux into the kidney with blunting of the calyceal angles and/or mild ureterectasis Grade 4: Reflux into the kidney with hydrouretronephrosis Grade 5: Reflux into the kidney with marked hydroureternephrosis and ureteral tortuosity © 2006 Humana Press Inc.