Diagnosis of vesicoureteral reflux
Last reviewed: 23.04.2024
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Laboratory and instrumental diagnostics of vesicoureteral reflux
Inflammatory changes in the kidneys and urinary tract can be accompanied by isolated urinary syndrome, mainly leukocyturia. Proteinuria is more common in older children, and its appearance in young children indicates gross renal changes against a background of vesicoureteral reflux.
The main method of diagnosis of vesicoureteral reflux is the mictorial cystography, in which, depending on the degree of casting of the X-ray contrast medium, five degrees of vesicoureteral reflux are isolated.
There are indirect signs of vesicoureteral reflux according to ultrasound: scattered cup-pelvis complex, pyeloectasia more than 5 mm, widening of various sections of the ureter, uneven contours of the bladder, defects in its filling.
When conducting urography, it is also possible to suspect the course of reflux by indirect signs: deformation of the pelvic cavity; hypotension of the ureters and pelvis, deformity of the calyx; expansion and increase of contrasting of the lower third of the ureter; hydronephrosis; "mute" kidney; cicatricial changes in the kidneys.
On radioisotope renoscintiography there is a violation of the excretory function of the kidneys, defects of one of the segments. With late diagnosis of reflux, there are irreversible changes in the upper urinary tract and the following complications: "functional obstruction" in the area of vesicoureteral reflux; overgrowth of the upper urinary tract with the formation of urethrohydronephrosis, the degree of which depends on the volume of reflux; the formation of reflux-nephropathy.
Thus, the following clinical manifestations make it possible to single out a "risk group" for the presence of vesicoureteral reflux: repeated bladder dysfunction, especially if they are combined with changes in urinalysis, mainly leukocyturia; unreasonable recurring temperature rises; pain in the abdomen, especially associated with the act of urination.
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