Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
A Novel Radiological Sign Associated with Vesicoureteral Reflux and Urinary Bladder Volume in Children: A Clinical Study
Çocuklarda Vezikoüreteral Reflü ve Mesane Volümüyle İlişkili Yeni Bir Radyolojik Belirti: Klinik Çalışma
Emin ÇAKMAKCIa, Çiğdem ÜNERa, Nagihan BAŞa, Hülya ŞEKER YIKMAZb, Çağanay SOYSALc
aClinic of Radiology, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, TURKEY
bClinic of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, TURKEY
cClinic of Obstetrics and Gynecology, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, TURKEY
J Reconstr Urol. 2021;11(2):43-9
doi: 10.5336/urology.2021-81827
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of the current study was to investigate demographic, clinical and radiological factors prone to influence urinary bladder volume in vesicoureteral reflux with special attention to hypoplasia of the 5th lumbar vertebra. Material and Methods: This retrospective study was performed using data derived from pediatric patients who were admitted to the pediatric urology department of our tertiary care center between 2010 and 2015 with complaints consistent with vesicoureteral reflux. A total of 104 children were subgrouped into two according to age (<72 months and ≥72 months). Demographic data, clinical findings, radiological data including hypoplasia of the fifth lumbar vertebra and results derived from voiding cystourethrogram, scintigraphy and ultrasonography were gathered and analyzed. Results: In children <72 months, incidence of vesicoureteral reflux was remarkably higher and volume of urinary bladder was significantly increased in children with diminished height of 5th lumbar vertebra corpus (p<0.001). On the other hand, findings derived from scintigraphy and ultrasonography were not different in patients with diminished height of 5th lumbar vertebra corpus. In children ≥72 months, frequency of vesicoureteral reflux was notably higher in children with lower height of vertebral body corpus (p=0.001). However, there was no difference between children with normal and decreased 5th lumbar vertebra corpus in terms of urinary bladder volumes (p=0.970). Conclusion: We suggest that hypoplasia of 5th lumbar vertebra can be a novel and practical radiological clue that may aid in the diagnosis of vesicoureteral reflux in children. However, further controlled trials on larger series are essential for understanding its clinical significance.

Keywords: Vezikoüreteral reflü; vertebral cisim; mesane
ÖZET
 Amaç: Bu çalışmanın amacı, 5. lomber vertebra hipoplazisine özellikle dikkat ederek vezikoüreteral reflüde mesane volümünü etkilemeye eğilimli demografik, klinik ve radyolojik faktörleri araştırmaktır. Gereç ve Yöntemler: Bu retrospektif çalışmada, 2010-2015 yılları arasında 3. basamak sağlık merkezimizin çocuk ürolojisi bölümüne vezikoüreteral reflüye uyumlu yakınmalarla kabul edilen çocuk hastalar çalışmaya dâhil edilmiştir. Toplam 104 çocuk yaşa göre 2 alt gruba (<72 ay ve ≥72 ay) ayrılmıştır. Demografik veriler, klinik bulgular ve 5. lomber vertebra hipoplazisini de içeren radyolojik veriler, işeme sistoüretrografisi, sintigrafi ve ultrasonografi sonuçları toplanmış ve analiz edilmiştir. Bulgular: Yetmiş iki aydan küçük, 5. lomber vertebra cisminin yüksekliği azalmış çocuklarda vezikoüreteral reflü insidansı belirgin derecede yüksekti ve üriner mesane volümü anlamlı derecede artmıştı (p<0,001). Diğer taraftan sintigrafi ve ultrasonografiden elde edilen bulgular 5. lomber vertebra cismi azalmış hastalarda farklı değildi. Yetmiş iki aylık veya daha büyük, vertebra cismi yüksekliği daha düşük çocuklarda vezikoüreteral reflü sıklığı belirgin derecede daha yüksekti (p=0,001). Ancak mesane volümleri açısından 5. lomber vertebra cismi normal ve azalmış çocuklar arasında herhangi bir farklılık yoktu (p=0,970). Sonuç: Beşinci lomber vertebra hipoplazisinin çocuklarda vezikoüreteral reflü tanısına yardımcı olabilen yeni ve pratik bir radyolojik ipucu olduğunu düşünmekteyiz. Ancak bunun klinik önemini anlamak için daha geniş serilerde kontrollü çalışmaların yapılması gereklidir.

Anahtar Kelimeler: Vesicoureteral reflux; vertebral body; urinary bladder
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