• Childhood Kidney Diseases
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• v.28 no.1
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• pp.1-7
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• 2024

Antenatally diagnosed urinary tract dilatation (UTD), previously referred to as antenatal hydronephrosis, is the most commonly detected abnormality by prenatal ultrasonography. Several grading systems have been developed for the classification of antenatal UTD using prenatal and postnatal ultrasonography. UTD comprises a wide variety of congenital abnormalities of the kidney and urinary tract ranging from transient UTD to more significant abnormalities such as vesicoureteral reflux, ureteropelvic junction obstruction, ureterocele, ureterovesical junction obstruction, posterior urethral valves, and non-refluxing megaureter. Optimizing the evaluation of antenatally detected UTD is essential to recognize children with important disorders while avoiding excessive investigations. Conservative approach with close follow-up is increasingly accepted as an appropriate treatment option for patients with asymptomatic vesicoureteral reflux and ureteropelvic junction obstruction in recent years. However, predicting permanent kidney damage in an unselected group of children with antenatal UTD is still challenging. The management and follow-up of children with UTD should be individualized based on recommendations from a pediatric nephrologist, a pediatric urologist, or both. Future research directed at predicting long-term outcomes of children diagnosed with UTD from mild findings to severe disease is needed to refine management for those at higher risk of kidney disease progression.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.106-111
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• 2003

We experienced a 4-month-old boy presenting with fever and painful scrotal swelling. Diagnostic work-up showed the presence of urinary tract infection and concurrent acute epididymitis. On the voiding cystourethrography, vesicoureteral reflux and urinary reflux through the ejaculatory duct and the seminal vesicle were detected without obvious urethral obstruction. In general, urinary reflux into the seminal vesicle can take place with obstructive lesions of the urethra and may cause epididymitis in infants. We report a case of urinary reflux without urethral obstruction with a brief review of related literatures.

• Journal of Veterinary Clinics
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• v.38 no.2
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• pp.63-68
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• 2021

Urethral obstruction is a life-threatening feline lower urinary tract disease (FLUTD). The rate of recurring urethral obstruction was 14.8-58.1% after the first occurrence. Ultrasonographic findings associated with reobstruction had been rarely reported although ultrasonography was a valuable technique for diagnosing urinary bladder calculi and distinguishing different FLUTD causes. This retrospective study aims to describe the ultrasonographic findings, urinalysis, and serum chemistry profile in cats with FLUTD and determine the associations of reobstruction with ultrasonographic findings, urinalysis, and serum chemistry profile. The present study included 141 cats that were followed up for more than 1 year. The ultrasonographic criteria included the presence of cystolithiasis, urine echogenicity, sediment, suspended linear strand, pericystic effusion, hyperechoic pericystic fat, ureteral dilation, pyelectasia, and perirenal effusion. The urinalysis criteria included hematuria, urine-specific gravity, pH, sediment, and proteinuria. The most common ultrasonographic findings in cats with FLUTD were echogenic urine and sediment. However, this study did not find an association between reobstruction and ultrasonographic findings, urinalysis, and serum chemistry profiles. Thus, an ultrasonographic examination may be insufficient to predict the risk of reobstruction although it is a useful modality for diagnosing FLUTD and making treatment direction.

• Journal of Biomedical Engineering Research
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• v.31 no.4
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• pp.302-309
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• 2010

The present study proposed a method of measuring uroflow and urophonography at the same time for more accurate diagnosis in case uroflow looks normal due to compensatory function hypertrophy in the expression of early obstruction. In case of early obstruction, there happens turbulent uroflow by the obstruction even if the uroflow looks normal and thus obstruction can be detected by measuring and analyzing signal caused by turbulent flow. We implemented a system that can measure both uroflow and urophonography, and evaluated its performance. In the experiment, we observed changes in uroflow and urophonography according to artificial pressure and the degree of obstruction, and confirmed that it is possible to determine the effect of compensatory function hypertrophy by analyzing urophonographyic parameter under the same uroflow. The results of our experiment show that the effect of compensatory function hypertrophy in the early-stage obstruction of lower urinary tract, which is not detectible with uroflowmetry alone, can be assessed through urophonographic analysis.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.181-185
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• 2012

An 11-year-old, intact female Shihtzu showing anuria was diagnosed as a urethral leiomyoma. The tumor occupied and obstructed the urethral lumen. In this report, the urethral tumor and secondary obstruction could be diagnosed via ultrasonography and contrast study such as excretory urography and voiding urethrography. Ultrasonography revealed a hypoechoic, demarcated urethral mass in proximal urethra. Contrast study confirmed the urethral obstruction and ruled out the expansion of the tumor into the urinary bladder. The clinical signs of the dog were completely resolved after removing the urethral mass and urethral anastomosis. Leiomyoma is a benign smooth muscle tumor, and rarely reported in lower urinary tract.

• Neonatal Medicine
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• v.18 no.2
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• pp.379-382
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• 2011

Spontaneous intraperitoneal extravasation of urine is rare. Perirenal urinoma may develop when obstruction to urinary flow creates sufficient back pressure to produce extravasation of urine. Urinary ascites most commonly indicate a disruption to the integrity of the urinary tract. We report a case of urinary ascites with urinoma resulting from an ureteropelvic junction obstruction in a neonate.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.67-72
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• 1997

Purpose : Congenital urinary tract anomaly is the most common anomaly in the childhood and progress to chronic renal failure and growth retardation. Therefore, early diagnosis arid treatment of urinary tract anomaly are important. Method : We reviewed medical records of 124 patients who had urinary tract anomalies on radiologic studies from Jan. 1986 to Dec. 1996. We analyzed demography and clinical characteristics of urinary tract anomalies. Results : 1) The age distributions were as follows ; 61 cases of 124 patients (49%) were under 1 year, 11 cases (8.8%) from 1 to 3 years, 20 cases (16%) from 4 to 6 years, 10 cases (8%) from 7 to 9 years, 9 cases (7.2%) from 10 to 12 years, 10 cases (8%) from 13 to 15 years, and 3 cases (2.4%) from 16 to 18 years. 2) Chief complaints in patients with urinary tract anomalies were fever, flank pain, prenatally diagnosed hydronephrosis, abdominal mass, dysuria and hematuria. 3) Of 124 patients, 68 cases(54.8%) were combined with urinary tract infection, and main causative organism was E.coli, and the most frequently associated anomaly was vesicoureteral reflux. 4) Most of the urinary tract anomalies were VUR, UPJ obstruction, congenital hydronephrosis and double ureter in order of sequence. 5) Whereas the frequency of simple urinary tract anomaly was 87.9%, that of complex anomaly was 12%. 6) Operative corrections were needed in 47 cases and 7 cases were progressed to renal insufficiency. Conclusion : We emphasize that early detection of urinary tract anomaly, appropriate treatment and regular follow-up are needed.

• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.202-205
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• 2003

A 10 days old male infant with congenital megacalyces and megaureter, diagnosed by prenatal ultrasonographic screening, underwent Tc-99m DTPA renal scan for evaluation of urinary tract patency, Tc-99m DMSA scan for evaluation of renal cortical damage. He also underwent intravenous urography(IVU) and renal ultrasonography. Tc-99m DTPA renal scan demonstrates intense tracer accumulation in enlarged both renal pelvocalyses and ureters, which rapidly washout without diuretics administration. Tc-99m DMSA renal cortical scan shows no remarkable photon defect in both renal cortices and visible tracer uptake in both megaureter areas. Ultasonographic and IVU studios show enlarged both renal calyses and bullously dilated ureters, but no dilatation in renal pelvis. Follow up Tc-99m DTPA renal scan, peformed at one year later, also reveals intense tracer accumulation in enlarged both urinary tracts which rapidly washout without diuretics, and shows no significant change compare to the previous Tc-99m DTPA renal scan. Urinary tract obstruction and renal cortical damage can be easily evaluated with Tc-99m DTPA and Tc-99m DMSA scans in patiens with megacalyces and megaureter.

• Journal of Sensor Science and Technology
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• v.16 no.3
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• pp.202-210
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• 2007

The aim of this study is to acquire useful information of lower urinary tract symptom (LUTS) diagnosis through urophonography signal as a noninvasive method. The hardware and software which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and urophonography signal during urination. The PSD (power spectrum density) and the log-log plot gradient analysis were accomplished in frequency domain. For evaluation of the system and analysis method, a model system for the lower urinary system of men was used. From the evaluation of the model system, the PDS and the log-log plot gradient were dependent on the occlusion degree significantly. In a pilot study on normal and abnormal male subjects, the PSD and the log-log plot gradient were highly correlated with the artificial urethral obstruction.

• Childhood Kidney Diseases
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• v.3 no.1
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• pp.88-94
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• 1999

Purpose : Malformation of urinary tract is among the most common of all congenital anomalies and can progress to irreversible renal damage before diagnosis due to difficulty of early diagnosis. Present study was undertaken to determine the clinical characteristics of urinary tract anomaly and to find out the most appropriate diagnostic and therapeutic measures for children with these anomalies. Methods : During the past 10 years from 1987 to 1998, review of medical records revealed 65 children with congenital anomaly of urinary tract and the following results were obtained. Results : The most common anomalies were ureteropelvic junction obstruction occuring in 26 cases ($36\%$), followed by ureteral duplication in 11 cases, renal agenesis in 10 cases and ureterovesical function obstruction in 7 cases. Complex anomaly of urinary tract was found in 8 cases and anomaly of other systems such as congenital heart disease was detected in 11 cases. The most frequent age group at the time of diagnosis was below 1 year of age constituting 39 cases ($60\%$) and male preponderance was noted as male to female ratio being 2.25:1. Presenting symptoms were urinary tract infection in 25 cases, followed by hematuria, abdominal mass, abdominal pain and voiding difficulty, etc, and in 11 cases, the anomaly was picked up by routine prenatal ultrasonography. Azotemia was noted in 9 cases and the underlying anomaly was obstructive uropathy in 4 out of these 9 cases. Surgical correction was undertaken in 38 cases (most frequently in cases of obstructive uropathy) and in 2 out off cases with obstructive uropathy in whom surgical correction was done, azotemia disappeared during follow up period of 1-5years. No new cases of deteriorating renal function appeared during follow-up period. Conclusion : In spite of high incidence of congenital malformation of urinary tract, early diagnosis is still hampered by nonspecific symptoms and signs. Therefore, in patients with symptoms such as urinary tract infection, abdominal pain and voiding problems, etc, it Is advisable to take various diagnostic tests promptly to pick up any urinary tract anomaly and to apply proper therapy in order to avoid progression to irreversible renal damage. In this regard, prenatal ultrasonography should be utilized more widely as a routine procedure to detect any urinary tract anomalies before birth.