Congenital abnormalities of the kidney and urinary tract

Question 1

What is VUR?

Answer 1

Retrograde passage of urine from the bladder to the upper urinary tract.

Question 2

How does VUR present in kids?

Answer 2

UTI. Also hydro-ureto-nephrosis

Question 3

How is VUR graded?

Answer 3

1 - reflux into ureter
2 - reflux to renal pelvis
3 - reflux to renal pelvis with dilatation
4 - + loss of fornices angle
5 - loss of papillary impression and gross dilatation

Question 4

How is VUR diagnosed?

Answer 4

MCUG shows dye refluxing to kidneys.

Question 5

What are complications of VUR?

Answer 5

Renal scarring which can lead to hypertension.

Question 6

How is VUR managed?

Answer 6

High grade - antibiotics prophylaxis for UTI

STING procedure, ureter re-implantation

Question 7

What are causes of obstruction?

Answer 7

Posterior urethral valve (males)
BPH
Neurogenic bladder
Prune Belly syndrome

Question 8

What is PUJO?

Answer 8

Pelvic-ureto-junction obstruction.

Presents with mass, pain, haematuria and can cause hydronephrosis.

Question 9

What is VUJO?

Answer 9

Vesico-ureto- junction obstruction.

Not as severe as PUJO

Question 10

How is congenital obstruction treated?

Answer 10

Observe to see if they resolve

Pyeloplasty: reconstruct renal pelvis to decompress kidney.

Question 11

How is obstruction diagnosed?

Answer 11

MAG3