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PUV was diagnosed if the posterior urethra showed typical dilatation on VCUG, and/or if valves were visualised at cystoscopy.
Also during annual follow-up sonography, if hydronephrosis or UTI was detected, the patient was evaluated by VCUG or RNC once again.
Caption: FIGURE 1: Antegrade VCUG via the suprapubic catheter after surgery for bladder rupture; full-length urethral dilation is evident up to point of obstruction (black arrow).
The report emphasized that normal prenatal US findings may not be sufficient to obviate the need for additional studies if a UTI occurs in infancy and that the accumulated evidence was not supporting antimicrobial prophylaxis to prevent UTI when VUR is found through VCUG. Finally, performance of VCUG after the first UTI for children between 2 and 24 months of age was not recommended anymore.
VCUG demonstrated grade III VUR 3 months later, and the cystostomy catheter was removed after clamping for 1 week without febrile UTI.
The number of patients with a normal Ultra sound who would need to undergo VCUG to detect one case of high-grade VUR was 70; the number needed to test to detect one case of low-grade VUR was 4, she said.
Iodine contrast agents are used for various procedures like Angiography (arterial investigations), Venography (venous investigations), VCUG (voiding cystourethrography), HSG (hysterosalpinogram), IVU (intravenous urography) etc.
Voiding cystourethrogram (VCUG) was performed on 97 patients (67.4%), 79 were normal and 18 patients had some degree of VUR, which is equivalent to 18.5% of the study population with VCUG.
VCUG may be limited in determining the anatomy of bladder neck pre-operatively.
Consequently, postnatal management is heterogeneous, with some centers advocating detailed investigations including voiding cystourethrography (VCUG) in all cases and others indicating a less intensive approach [12-16].
Intravenous urogram (IVU) and voiding cystourethrography (VCUG) to rule out vesicoureteric reflux (VUR) were also done selectively.
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