Can an ultrasound reliably show whether a child's backward urine flow has resolved after injection treatment?

Details

The study examined whether the presence or absence of dextranomer-hyaluronic acid copolymer mounds on bladder ultrasound agreed with voiding cystourethrogram results after injection therapy in children with primary vesicoureteral reflux.

Researchers retrospectively reviewed consecutive cases of dextranomer-hyaluronic acid copolymer injection for primary vesicoureteral reflux. The primary outcome was the appearance of these mounds on postoperative ultrasound and its association with postoperative voiding cystourethrogram results. A mound within the bladder wall on ultrasound was classified as a negative test result for vesicoureteral reflux.

Of 187 identified cases, 132 had imaging available for evaluation. Postoperative ultrasound showed intramural mounds in 86 cases; 34 of these (40%) had a positive voiding cystourethrogram. In the 46 cases with no mound identified, 21 (46%) had a positive voiding cystourethrogram.

For determining the presence or absence of vesicoureteral reflux, ultrasound had a sensitivity of 38%, specificity of 67%, accuracy of 55%, positive predictive value of 46%, and negative predictive value of 60%.

The researchers concluded that the appearance of dextranomer-hyaluronic acid copolymer mounds on ultrasound correlated poorly with voiding cystourethrogram results after injection. They stated that a voiding cystogram or nuclear medicine cystogram needs to be performed after injection therapy to adequately evaluate whether vesicoureteral reflux has resolved.