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Vesicoureteric Reflux and Radionuclide Cystography

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Pediatric Nuclear Medicine

Abstract

Vesicoureteric reflux (VUR) is caused by failure of the ureterovesical valve mechanism. This failure may be due to a congenital variation, pathologic process, infection, or immaturity that distorts the anatomy or function (or both) of the ureterovesical junction. Passive and active factors characterize the normal valve mechanism of the ureterovesical junction. Passive factors include the oblique entry of the ureter into the bladder; the length of the intramural ureter, particularly of its submucosal segment; and the ratio of the length of the submucosal tunnel to the diameter of the ureter. The active factors include contraction of the ureterotrigonal muscles, which close the ureteral meatus and the submucosal tunnel, and active ureteral peristalsis, as seen during diuresis.33 The intravesical ureter becomes longer with age, often producing sufficient length to convert a refluxing ureterovesical junction into a nonre-fluxing one.

How many brothers and sisters do you have? I have three brothers and one sister, and I am the sister. Kate, 5 years old

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References

  1. Bailey RR. Sterile reflux: is it harmless? In Hodson J, Kinkaid SP (eds): Reflux Nephropathy. New York: Masson, 1979

    Google Scholar 

  2. Berger RM, Maizels M, Moren GC, Conway J, Firlit CF. Bladder capacity (ounces) equals age (years) plus 2 predicts normal bladder capacity and aids in diagnosis of abnormal voiding patterns. J Urol 1983;129:347–349

    CAS  PubMed  Google Scholar 

  3. Bower G, Lovegrove FT, Geijsel H. Comparison of direct and indirect radionuclide cystography. J Nucl Med 1985;26:465–468

    CAS  PubMed  Google Scholar 

  4. Buonomo C, Treves ST, Jones B, et al. Silent renal damage in symptom-free siblings of children with vesicoureteral reflux: assessment with technetium-99m dimercaptosuccinic acid scintigraphy. J Pediatr 1993;122:721–727

    Article  CAS  PubMed  Google Scholar 

  5. Conway JJ, Belman AB, King LR. Direct and indirect radionuclide cystography. Semin Nucl Med 1974; 4:197–211

    Article  CAS  PubMed  Google Scholar 

  6. Conway JJ, Kruglick GD. Effectiveness of direct and indirect radionuclide cystography in detecting vesicoureteral reflux. J Nucl Med 1976;17:81–83

    CAS  PubMed  Google Scholar 

  7. Cremin BJ. Observations on vesico-ureteric reflux and intrarenal reflux: a review and survey of material. Clin Radiol 1979;30:607–621

    Article  CAS  PubMed  Google Scholar 

  8. Dilman LD, Van der Lage FC. Radionuclide decay schemes and nuclear parameters for use in radiation dose estimation. In: MIRD Pamphlet No. 10. New York: Society of Nuclear Medicine, 1975

    Google Scholar 

  9. Fairhurst JJ, Rubin CME, Hyde I, Freeman NV, Williams JD. Bladder capacity in infants. J Pediatr Surg 1991;26:55–57

    Article  CAS  PubMed  Google Scholar 

  10. Faure C. Le reflux vesico-ureteral. In Lefebvre J (ed): Traite de Radiodiagnostic. Paris: Masson & Cie, 1973

    Google Scholar 

  11. Fendel H. Radiation exposure due to urinary tract disease. In Kaufmann HJ (ed): Progress in Pediatric Radiology. Basel: Karger, 1970:116–135

    Google Scholar 

  12. Friedland GW. Recurrent urinary tract infections in infants and children. Radiol Clin North Am 1977;15:19–35

    CAS  PubMed  Google Scholar 

  13. Gierup P. Micturition studies in infants and children. Scand J Urol Nephrol 1970;4:191–207

    Article  CAS  PubMed  Google Scholar 

  14. Gordon I, Peters AM, Mornoy S. Indirect radionuclide cystography: a sensitive technique for the detection of vesico-ureteral reflux. Pediatric Nephrology 1990;4:604–606

    Article  CAS  PubMed  Google Scholar 

  15. Hass EA, Solomon DJ. Telling children about diagnostic radiology procedures. Radiology 1977; 124:521

    CAS  PubMed  Google Scholar 

  16. Hodson CJ, Edwards D. Chronic pyelonephritis and vesicoureteric reflux. Clin Radiol 1960; 11:219–231

    Article  CAS  PubMed  Google Scholar 

  17. Hutch JA. Aberrant micturition. J Urol 1966; 96:743–745

    CAS  PubMed  Google Scholar 

  18. Hutch JA. Theory of maturation of the intravesical ureter. J Urol 1961 ;86:534–538

    CAS  PubMed  Google Scholar 

  19. International Reflux Study Committee. Medical versus surgical treatment of primary vesicoureteral reflux. Pediatrics 1981;67:392–400

    Google Scholar 

  20. Kenda RB, Fettich JJ. Vesicoureteric reflux and renal scars in asymptomatic siblings of children with reflux. Arch Dis Child 1992;67:506–508

    Article  CAS  PubMed  Google Scholar 

  21. King LR. Vesicoureteral reflux: history, etiology, and conservative management. In Kelalis PD, King LR, Belman AB (eds): Clinical Pediatric Urology. Philadelphia: Saunders, 1976

    Google Scholar 

  22. Koff SA. Estimating bladder capacity in children. Urology 1983;21:248

    Article  CAS  PubMed  Google Scholar 

  23. Lattimer JK, Apperson JW, Gleason DM, Baker D, Flemming SS. The pressure at which reflux occurs, an important indicator of prognosis and treatment. J Urol 1963;89:395–404

    Google Scholar 

  24. Leibovic SJ, Lebowitz RL. Reducing patient dose in voiding cystourethrography. Urol Radiol 1980; 2:103–107

    Article  Google Scholar 

  25. Loevinger R, Berman M. A revised schema for calculating the absorbed dose from biologically distributed radionuclides. In: MIRD Pamphlet No. 1. New York: Society of Nuclear Medicine, 1975

    Google Scholar 

  26. Lyon RP, Marshall S, Tanagho EA. Theory of maturation; a critique. J Urol 1970; 103:795–800

    CAS  PubMed  Google Scholar 

  27. Majd M, Kass EJ, Belman AB. Radionuclide cystography in children: comparison of direct (retrograde) and indirect (intravenous) techniques. Ann Radiol 1985;28:322–328

    CAS  PubMed  Google Scholar 

  28. Noe HN. The long term results of prospective sibling reflux screening. J Urol 1992;148:1739–1742

    CAS  PubMed  Google Scholar 

  29. Normand LCS, Smellie J. Vesicoureteric reflux: the case for conservative management. In Hodson J, Kincaid SP (eds): Reflux Nephropathy. New York: Masson, 1979

    Google Scholar 

  30. Orr WA, Kimbrough H, Gillenwater JY Alterations in renal blood flow with voiding in the presence of vesicoureteral reflux. J Urol 1971;106:214–219

    CAS  PubMed  Google Scholar 

  31. Pozderac RV, Becker CJ, Reitelman C, Kuhns LR. Comparison of single and two stage radionuclide cystography (RNC) for evaluation of reflux [abstract]. J Nuc lMed l990;31:893

    Google Scholar 

  32. Poznanski E, Poznanski A. Psychogenic influences on voiding: observations from voiding cystourethrography. Psychosomatics 1969;10:339–342

    CAS  PubMed  Google Scholar 

  33. Ransley PG. Vesicoureteric reflux. In Williams DI, Johnston JH (eds): Pediatric Urology. London: But-terworth, 1982

    Google Scholar 

  34. Rolleston GL, Mailing TJ, Hodson CJ. Intrarenal reflux and the scarred kidney. Arch Dis Child 1974; 49:531–539

    Article  CAS  PubMed  Google Scholar 

  35. Rolleston GL, Shannon FT, Utley WLF. Follow-up of vesicoureteric reflux in the newborn. Kidney Int 1975;4:S59-S64

    Google Scholar 

  36. Rolleston GL, Shannon FT, Utley WLF. Relationship of infantile vesicoureteral reflux to renal damage. BMJ 1970;70:460–463

    Article  Google Scholar 

  37. Smellie J, Edwards D, Hunter N, Normand ICS, Prescod N. Vesicoureteral reflux and renal scarring. Kidney Int 1975;4:S65-S72

    Google Scholar 

  38. Smith JC. Urethral resistance to micturition. Br J Urol 1968;40:125–155

    Article  CAS  PubMed  Google Scholar 

  39. Snyder WS, Cook MJ, Nasset ES. Report of the task group on reference man. In: The International Commission on Radiological Protection. Oxford; Pergamon Press, 1975

    Google Scholar 

  40. Snyder WS, Ford MR, Warner GG. Estimates of specific absorbed fractions for photon sources uniformly distributed in various organs of heterogenous phantom. In: MIRD Pamphlet No. 5. New York: Society of Nuclear Medicine, 1978

    Google Scholar 

  41. Spencer RP, Treves S. Bladder emptying flow rates as a function of bladder volume. Yale J Biol Med 1971;44:199–205

    CAS  PubMed  Google Scholar 

  42. Starfield B. Functional bladder capacity in enuretic and nonenuretic children. J Pediatr 1974; 111: 167–172

    Google Scholar 

  43. Stephens FD. Urologic aspects of recurrent urinary tract infections in children. J Pediatr 1972; 80:725–737

    Article  CAS  PubMed  Google Scholar 

  44. Stephens FD, Lenaghan D. The anatomical basis and dynamics of vesicoureteral reflux. J Urol 1962; 87:669–680

    CAS  PubMed  Google Scholar 

  45. Strauss BS, Balufox MD. Estimation of residual urine and urine flow rates without urethral catheterization. J Nucl Med 1970; 11:81–84

    CAS  PubMed  Google Scholar 

  46. Tanagho EA, Meyers FH, Smith DR. Urethral resistance: its components and implications. I. Smooth muscle component. Invest Urol 1969;7:136–149

    CAS  PubMed  Google Scholar 

  47. Tanagho EA, Meyers FH, Smith DR. Urethral resistance: its components and implications. II. Striated muscle component. Invest Urol 1969 ;7:195–205

    CAS  PubMed  Google Scholar 

  48. Treves ST, Mitchell K, Sheu E, Zurakowski D. Functional bladder capacity in children under 13 years of age: a non-linear relationship. In preparation, 1994

    Google Scholar 

  49. Van den Abbelle AD, Treves ST, Lebowitz RL, et al. Vesicoureteral reflux in asymptomatic siblings of patients with known reflux: radionuclide cystography. Pediatrics 1987;79:147–153

    Google Scholar 

  50. Whitaker J, Johnston GS. Urinary flow rate with two techniques of bladder pressure measurement. Invest Urol 1966;4:235–238

    CAS  PubMed  Google Scholar 

  51. Willi U, Treves ST. Radionuclide voiding cystography. Urol Radiol 1983;5:161–173

    Article  CAS  PubMed  Google Scholar 

  52. Willi U, Treves ST. Radionuclide voiding cystography. In Treves ST (ed): Pediatric Nuclear Medicine. New York: Springer-Verlag, 1985:105–120

    Google Scholar 

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Authors
  1. S. T. Treves
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  2. M. Gelfand
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  3. U. V. Willi
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Editor information

Editors and Affiliations

  1. Division of Nuclear Medicine, Children’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    S. T. Treves M.D. (Chief, Professor of Radiology) (Chief, Professor of Radiology)

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© 1995 Springer Science+Business Media New York

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Treves, S.T., Gelfand, M., Willi, U.V. (1995). Vesicoureteric Reflux and Radionuclide Cystography. In: Treves, S.T. (eds) Pediatric Nuclear Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4205-3_19

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  • DOI: https://doi.org/10.1007/978-1-4757-4205-3_19

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-4207-7

  • Online ISBN: 978-1-4757-4205-3

  • eBook Packages: Springer Book Archive

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