Methods to detect Occult VUR ?

• 01 Apr 2020 01:13:03 PM
• |Pediatic Urology

What are the methods to detect occult VUR or methods to unmask reflux during VUR? ( viva question)

Comments(1)

• 

  Ravindra Sabnis

  04 Apr 2020 02:41:47 PM

  You mean VUR is present but MCU does not show it. 

  This can happen in following situations

  1) When reflux is of low grade, it may be missed during MCU but usually of no consequences. 

  2) Some times X ray plate is not taken properly - when child has already passed urine or child is about to pass urine or while shooting child has temporarily stopped passing urine. this can happen as children they keep crying while doing MCU. solution - do MCU under fluroscopy

  3) Gross dilatation of lower ureter is behind the bladder reflux is only in ureter as dilatation & kinking is too much & hence does not reach upper ureter & because of contrast in bladder, it is not identifiable - Solution - always take oblique plate 

  4) In adult reflux is not seen because some find difficult to void on x ray machine & hence bladder neck does not open. Hence reflux which appears only during micturation is not seen. - solution give alpha blocker & do MCU 

  This is what I think are the reasons * solutions to unmask them.