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In grade V vur, high PVR can be due to flow of urine from upper tract after voiding. I feel
I agree with Prog. S S Joshi Sir and Rahul on pseudo high residual but how to explain very high residual seen in VCUG?
So in this case we will proceed with anti reflux sugery.
I think we still need to work on this case for persistence of such a huge reflux before we go ahead with bilateral tapering and reimplantation.
This child is 7 yrs old and his S.Crt is 1.1, so his kidneys must have been damaged.
Which would be the best center to do UDS for this patient? I mean to ask, who has experience in doingthis kind of UDS? (Can reply on my personal number also)
I feel Dr. SSJ sir has sumnerised all problems & solutions extremely well. I feel he does not need UDM - nothing will change after UDM. He needs reimplant with tapering. No extensive dissection of ureters. It will be counterproductive. Toutuocity will go once reflux stops. Favourable things in this case are - good capacity, no trabeculations.
As the patient has got high PVR and palpable bladder and normal cystoscopy, I think UDS is necessary, although high compliant ureters may create fallacy, in spite of that, in this situation high Pdet max and high Pdet Qmax might indicate BNI.