ESPU Congress 2017 - Abstract book

128

CONGRESS OF THE ESPU

S11-14 (P without presentation)

RADIATION EXPOSURE IN CHILDREN WITH POSTERIOR

URETHRAL VALVES DURING THE FIRST YEAR OF LIFE:

A NECESSITY OR AN AVOIDABLE OVERSIGHT?

Frank PENNA

, Lael REINSTATLER

, Kevin SHEE

, Rakan ODEH

, Hissan BUTT

Armando LORENZO

, Walid FARHAT

, Darius BÄGLI

and Martin KOYLE

1) Dartmouth | Geisel School of Medicine, Children’s Hospital at Dartmouth, Division of Pediatric Urology, Hanover,

USA - 2) The Hospital for Sick Children, Division of Paediatric Urology, Toronto, CANADA

INTRODUCTION

The diagnosis of posterior urethral valves (PUV) is confirmed postnatally with a voiding cystoure-

throgram (VCUG). Other imaging studies such as DMSA may be performed during the critical first

year of life. While certain studies are indicated to properly diagnose and treat the critically ill child,

we hypothesized that some studies, which carry radiation exposure, may be avoidable.

PATIENTS AND METHODS

A single institution retrospective review was performed of all children with a diagnosis of PUV over

a 10-year period, from 2003-2013. Patients were stratified into three groups at two time periods

(1 month and 1 year of age based on creatinine (Cr) range: Group I (<0.31 mg/dL), Group II (0.31-

1.03 mg/dL), and Group III (>1.03 mg/dL). Mean radiation exposure from imaging studies performed

during the first year of life was calculated for each group.

RESULTS

Thirty-three children were included in the study. The mean gestational age was 36.6 weeks (range

33-40). All except for 3 had a history of antenatal hydronephrosis; 7 had a history of oligohydram-

nios. The majority were treated with valve ablation; three had vesicostomy placement. Ten of the

children had a urinary tract infection in the first year of life. The table summarizes the mean Cr and

radiation exposure/patient by group.

Group

% Patients (at

1 mo.)

Mean Cr at

1 mo (mg/dL)

% Patients

(at 1 yr.)

Mean #

studies/patient

Mean

radiation/

patient (mSv)

26.1% 0.27 (0.24,

0.29)

23.1% 1.2

0.67 (0.5, 1.0) ref

47.8% 0.50 (0.33,

0.72)

57.7% 2.7

1.50 (1.0, 2.0) 0.0189

III

26.1% 1.53 (1.09,

1.63)

19.2% 2.3

1.33 (0.5, 2.0) 0.0856

CONCLUSIONS

Higher baseline creatinine is associated with a higher risk of radiation exposure from imaging stud-

ies during the first year of life. Cr at 1 month was not a predictive indicator of Cr at 1 year. Long-term

risks of radiation exposure to children is unknown, and therefore should be minimized.