Congenital Urinary Tract Dilatation and Obstructive Uropathy
The reported incidence of upper urinary tract dilatation (UTD) is 1–5.4 % of all pregnancies, dependent on the diagnostic criteria that are being applied, accounting to 60–120,000 children being diagnosed per year in the USA (Mallik and Watson 2008). Of these, around 25 % are persistent throughout birth (Barbosa et al. 2012). Sonographically detected intrauterine UTD can be observed in varying degrees in the 18th to 20th week of gestation. A prognostic cutoff level of prenatally diagnosed UTD on the basis of many studies has been determined; the risk of a significant UTDs after birth was linked to its prenatal manifestation (Nguyen et al. 2010): Whereas children with an anteroposterior renal pelvis diameter of ≥15 mm have a risk of 75 % of persistence after birth, in children with an anteroposterior renal pelvis diameter of ≤9 mm, it amounts to only 10 % (Benfield et al. 2003). The risk for later surgery is connected also with the grade of the prenatal urinary tract dilatation (Fig. 1).
- Chow JS, Darge K (2015) Multidisciplinary consensus on the classification of antenatal and postnatal urinary tract dilation (UTD classification system). Pediatr Radiol 13Google Scholar
- Nguyen HT, Herndon CD, Cooper C, Gatti J, Kirsch A, Kokorowski P, Lee R, Perez-Brayfield M, Metcalfe P, Yerkes E, Cendron M, Campbell JB (2010) The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol 6(3):212–231CrossRefGoogle Scholar
- Nguyen HT, Benson CB, Bromley B, Campbell JB, Chow J, Coleman B, Cooper C, Crino J, Darge K, Herndon CD, Odibo AO, Somers MJ, Stein DR (2014) Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system). J Pediatr Urol 10(6):982–998CrossRefGoogle Scholar
- Riccabona M, Avni FE, Blickman JG, Dacher JN, Darge K, Lobo ML, Willi U (2008b) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 38(2):138–145CrossRefGoogle Scholar
- Riccabona M, Lobo ML, Ording-Muller LS, Augdal TA, Avni FE, Blickman J, Bruno C, Damasio BM, Darge K, Ntoulia A, Papadopoulou F, Vivier PH (2017) ESPR Abdominal (GU and GI) Imaging Task Force – Imaging Recommendations in Paediatric Uroradiology, Part IX: imaging in anorectal and cloacal malformation, imaging in childhood ovarian torsion, and efforts in standardising pediatric uroradiology terminology. Report on the mini-symposium at the ESPR meeting in Graz, June 2015. Pediatr Radiol (in press)Google Scholar
- RIVUR Trial Investigators, Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, Pohl HG, Kropp BP, Skoog SJ, Nelson CP, Moxey-Mims M, Chesney RW, Carpenter MA (2014) Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med 370(25):2367–2376Google Scholar