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AUA guidelines > Vesicoureteral reflux > Flashcards

Vesicoureteral reflux Flashcards

1
Q

What is recommended in the evaluation of VUR?

A 
Hight
Weight
Blood pressure
Cr 
UA
RUS
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2
Q

What is an option for evaluating VUR?

A

DMSA scan

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3
Q

What is the effect of BBD on VUR?

A

Can decrease the success rate of CAP from 61% to 31%. Endoscopic surgery from 89% to 50%. But does not influence surgical resolution rates (97%).

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4
Q

What questions should be asked during VUR evaluation?

A 
frequency/urgency
Voiding intervals
incontinence
Perineal pain
Holding maneuvers
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5
Q

What are the 3 goals of VUR treatment?

A
  1. prevent UTIs
  2. Prevent renal injury
  3. minimize tx morbidity
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6
Q

Tx for child < 1 year old with febrile UTI and VUR?

A

CAP

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7
Q

Tx for child < 1 year old with VUR but no febrile UTIs?

A

CAP if VUR III-V

CAP not necessary for VUR I-II

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8
Q

What other treatment can be offered to males with VUR?

A

Circumcision to reduce the risk of UTI.

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9
Q

Child > 1 year old with VUR and BBD. What is the first line tx?

A

Treat BBD

Give CAP while tx BBD.

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10
Q

Child > 1 year old with VUR and no BBD. First line tx?

A

Observation

Abx only for UTIs

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11
Q

How should children with VUR be followed up?

A

BP, height, weight, UA, RUS, annually. VCUG every 2 years.

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12
Q

Abnormal RUS in the context of VUR. What is the next step?

A

Obtain DMSA scan.

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13
Q

What is the resolution rate for open surgery for VUR?

A

98.1%

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14
Q

What is the resolution rate for endoscopic management of VUR?

A

83%

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15
Q

What is the rate of post operative urinary obstruction following surgical management of VUR?

A

0.4%

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16
Q

What should be obtained at follow up for surgical management of VUR?

A

RUS

VCUG

17
Q

How should VUR be followed after resolution?

A

Height, Weight, BP, UA annually. If either kidney is abnormal then obtain yearly RUS or DMSA scans.

18
Q

What is the rate of VUR in siblings of a VUR patient?

A

27%, Screen with VCUG if siblings have history of UTI.

19
Q

What is the incidence of VUR in patients with prenatal hydronephrosis?

A

16%

20
Q

Child with Grade III-IV hydronephrosis, hydroureter, and abnormal bladder, may have developed UTI. Next step?

A

VCUG

21
Q

Grade I-II prenatal hydronephrosis?

A

Observation

22
Q

Breakthrough febrile UTI with VUR. Next step?

A

Endoscopic bulking injections or open surgery are recommended. Alternative antibiotic is an option.

AUA guidelines (7 decks)

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