VCUG Not Required for Mild Hydronephrosis.
Prenatal ultrasonography frequently identifies mild hydronephrosis in the fetus, but the significance of the finding remains unclear. "All of us get many referrals to follow up on these cases," said Dr. Arjonilla, a pediatric radiologist at Hospital La Paz in Madrid.
She reviewed the voiding cystourethrograms (VCUGs) done on 468 kidneys in infants. A total of 308 kidneys had been identified on prenatal ultrasound as showing mild hydronephrosis, defined as a renal pelvic anteroposterior diameter of 515 mm. The other 160 kidneys were normal contralateral organs.
Only 99 kidneys (32%) showed vesicoureteral reflux on VCUG. The others showed no reflux.
More significantly 36(23%) of the "normal" kidneys also showed vesicoureteral reflux that had not presented any clinical problems.
"There was no significant difference in the incidence of reflux between kidneys that showed mild hydronephrosis and those that did not," Dr. Arjonilla said.