Generally, upper urinary tract damage is detected by cystourethrogram
, video urodynamic studies, or other image examinations.
Before surgery, all participants were evaluated regarding AP diameter and cortical thickness of affected kidney by ultrasonography, which were all done by the same radiologist, 99technetium DTPA renal scan and voiding cystourethrogram
were performed (to assess VUR).
Initial radiological investigations consisted of abdominopelvic ultrasound followed by voiding cystourethrogram
and cystoscopy (where appropriate size scope was available) when patients had been clinically stabilised.
Urethral diverticula were diagnosed by voiding cystourethrogram
performed at the time of videourodynamics or by magnetic resonance imaging (MRI).
A voiding cystourethrogram
(VCUG) is recommended by the pediatric radiologist.
Investigations included ultrasound kidneys, renal scintigraphy (MAG-3) and micturating cystourethrogram
showed bilateral severe (grade 5) vesicoureteral reflux with normal urethra.
The recommended imaging studies during the study period included the completion of an ultrasound (US) examination during hospitalization or after hospitalization in all cases of infants <2 months of age with UTI and performance of a voiding cystourethrogram
(VCUG) after 6-8 weeks following the discharge from the hospital.
If there is any evidence of urethral injury or a positive cystourethrogram
, a suprapubic Foley catheter needs to be inserted during the index procedure to ensure the diversion of urine.
The diagnosis was established by the voiding cystourethrogram
, which revealed intraperitoneal extravasation of contrast opacification of urinary bladder with features consistent with intraperitoneal bladder rupture.
We learned medical history of the patients and performed examinations of intravenous pyelogram (IVP), voiding cystourethrogram
(VCUG) and ultrasonography, patients with secondary VUR (lower urinary tract obstruction) were excluded.
It was an impossible sum for the full-time mother and University of South Wales social care student so friend Sarah Green suggested opening a gofundme page online to seek donations for the operations - a micturating cystourethrogram
and a PIC cystography.