P328 Micturating cystouretehrography in diagnosis of vesicoureteric reflux, a clinical practice

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Vesicoureteric reflux (VUR) represents one of the most common anomalies of urinary tract that mostly occurs in young children but as well as in older ones. Aetiology is mostly unknown, but in most individuals reflux results from a congenital anomaly of the ureterovesical junction. On clinical presentation there are different symptoms and very unpredictable reactions on all aplied methods of treatment. According to International classification of VUR, it is classified on five degree levels. It is very important on micturating cystourethrogram (MCUG) to determine exact level because it further determined way of treatment. So, first and second degree are terated noninvasively, fourth and fifth are invasive. Treatment of the third degree is very problematic but the stand is that zou should certainly start noninvasively, and after the follow up within 3 to 6 months you would be able to further determine treatment.

In General Hospital of ‘Studenica’ from 1991 there were 3396 MCUG procedures done. This time period we split in two parts, first until the year 2000 when in our health centre we didn t have paediatric nephrologist nor urologist and when there was confusion within the symptom area for MCUG. At that time, positive results percentage was only 12% but we also found patents older than age 20 with VUR.

Second part is the period after 2000 when we started having paediatric radiologist,nephrologist and urologist.Now within symptom area we have destinctive criteria, so percentage of positive results are larger than 44% with tendency to grow, and for 12 years we didn tfind newly discovered VUR in children older than age of 5. The importance of early indication for recommending MCUG, determining the right degree of VUR and especially the cooperation among clinics is the base for successful treatment of this anomaly with unpredictable conseqences which are very hard to diagnose and treat.

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