ESPU Congress 2018 - Abstract Book

54 29 th CONGRESS OF THE ESPU S5: VESICOURETERAL REFLUX 2 Moderators: Goedele Beckers (Netherlands), Alexander Springer (Austria) ESPU Meeting on Thursday 12, April 2018, 08:52–09:34 08:52–08:55 S5-1 (PP) ★ POSTNATAL IMAGING OF PRENATALLY DETECTED HYRONEPHROSIS – WHEN IS VOIDING CYSTOURETHROGRAM NECESSARY? Sofia VISURI  1 , Reetta KIVISAARI  2 , Timo JAHNUKAINEN  3 and Seppo TASKINEN  1 1) Helsinki University Hospital, Department of Pediatric surgery, Helsinki, FINLAND - 2) Helsinki University Hospital, Department of Pediatric Radiology, Helsinki, FINLAND - 3) Helsinki University Hospital, Department of Pediatric Nephrology and Transplantation, Helsinki, FINLAND PURPOSE To evaluate whether grade 4–5 vesicoureteral reflux (VUR) and increased risk for UTI can be predicted from renal ultrasound (RUS) findings and perform voiding cystourethrograms (VCUGs) only on high-risk patients. MATERIAL AND METHODS After ethical approval RUS and VCUG images of infants with prenatally detected hydronephrosis (HN) admitted to our institution between the years 2003–2013 were re-evaluated. The UTI epi- sodes were collected retrospectively from the patient journals. Patients with complex urinary tract anomalies were excluded. RESULTS One-hundred-eighty patients (352 renal units (RU)), 23 (30 RU) of them having grade 4–5 VUR were included. The median age of the patients at the time of the RUS was 1.3 (0.1–3.0) months and the median follow up-time was 2.0 (0.1–11.2) years. In multivariate analysis, a visible ureter (OR 12.72; CI 5.33–32.04, p<0.001) and shorter renal length (OR 2.67; CR 1.50–4.86, p<0.001) in RUS predicted grade 4–5 VUR while a visible ureter predicted UTI (OR 5.93; CI 2.83–12.30, p<0.001). A three-grade risk score was developed based on the RUS findings and the patients were catego- rized into low-, intermediate- and high-risk groups. The incidence of grade 4–5 VUR was 2.9 % in the low-risk, 12.2 % in the intermediate-risk and 52.2 % in the high-risk groups. The sensitivity for detecting grade 4–5 VUR was 79 % and the specificity 82 % respectively. CONCLUSIONS A visible ureter and reduced renal length in RUS are significant risk factors for high-grade VUR. Our results suggest that by using RUS based risk scoring a significant portion of unnecessary VCUGs can be avoided.