ESPN 51th Annual Meeting

ESPN 2018


 
Is Voiding Cystourethrography Necessary For The Evaluation of Unilateral Ectopic Pelvic Kidney?
AHMET MIDHAT ELMACI 1 MUHAMMET İRFAN DÖNMEZ 2 MUSTAFA SORAN 1

1- KONYA DR.ALI KEMAL BELVIRANLI WOMENS MATERNITY AND CHILDRENS HOSPITAL
2- KONYA TRAINING AND RESEARCH HOSPITAL
 
Introduction:

It has been reported that vesicoureteric reflux (VUR) has been observed 30% of simple renal ectopy. The aim of our study is to reveal clinical manifestations of unilateral ectopic pelvis kidney and show if voiding cystrourethrography (VCUG) is required in the evaluation of this entity.

Material and methods:

Data analysis of two pediatric nephrology clinics between 2011 and 2017 were conducted retrospectively and those that included ectopic pelvic kidneys were abstracted. Age, gender, type of presentation, laterality, incidence of hydronephrosis, incidence of VUR and differential renal function on dimerkaptosuccinic acid (DMSA) scintigraphy were evaluated. Other types of renal ectopia (cross fused, pancake kidney etc.) were excluded.

Results:

A total of 72 patients were found to have unilateral ectopic pelvic kidney. Study cohort consists of 31 males and 41 females with a mean age of 5±4.4 years. Ectopic kidneys were incidentally found in 41 patients while 8 had prenatal diagnosis. Moreover, 10 patients were identified during work-up for urinary tract infections (UTI) and 5 were diagnosed during evaluation for abdominal pain. Microscopic hematuria was observed in 7 patients. There were 28 left-sided and 44 right-sided ectopic kidneys. As per DMSA, mean differential renal function of the ectopic kidneys was reduced (38 ± 7.8%). VCUG was obtained in 42 however VUR was found only in 1 (2%). Additionally, in great contradiction with previous studies, only 2 patients showed hydronephrosis. In a median of 16.5 months of follow-up, 8 patients had UTI (4 of those have presented with UTI, initially). Seven patients had non-urogenital abnormalities, as well.

Conclusions:

Although previous reports and many textbooks indicate VUR is the most common abnormality associated with ectopic pelvic kidney, our findings reveal a very low incidence. Therefore, we advice VCUG should only be obtained in clinically indicated patients.