Purpose or Case Report: We will discuss how to perform voiding cystourethrography (VCUG). We will illustrate typical imaging features of genitourinary pathologies in a neonate.
Methods & Materials: We will briefly discuss the pathophysiology and imaging features of vesicoureteral reflux (VUR). In our exhibit, we will discuss the method of performing an optimal VCUG and illustrate the I-V grades of VUR.
Results: There is a high incidence of asymptomatic hydronephrosis in newborns. The degree of prenatal urinary tract dilatation does not dictate postnatal VCUG. Unilateral hydronephrosis of any grade, if asymptomatic, can be managed conservatively. Severe obstructive uropathy patients should undergo surgical repair before functional renal damage and irreversible deterioration occurs. Optimal decision-making requires interdisciplinary cooperation between radiologists, pediatric urologists, and nephrologists. Ultrasound is frequently performed in infants with urinary tract infections (UTI) to rule out renal anomalies. Febrile urinary tract infections (UTI) and vesicoureteral reflux (VUR) may predispose to renal scarring, resulting in hypertension or chronic kidney diseases in later life. All infants should undergo voiding cystourethrogram (VCUG) after their first febrile UTI. The probability of vesicoureteral reflux in infants with UTI and sonographic abnormalities increases with age. About 40% of patients with a solitary kidney have associated renal anomalies. VUR is the most common anomaly associated with a unilateral multicystic dysplastic kidney (MCDK). VUR should be evaluated in cases of ureteropelvic junction (UPJ) obstruction with recurrent febrile UTIs, dilated ureter, or before potential surgical intervention.
Conclusions: UTIs and VUR are common in infants. VCUG is routinely performed in pediatric radiology to detect vesicoureteral reflux (VUR) or diagnose pathologies such as a posterior urethral valve. We illustrate an imaging spectrum of VUR and other neonatal genitourinary pathologies.