Vesicoureteral Reflux in Neonates with Hydronephrosis; Role of Imaging Tools

Neonatal hydronephrosis is a common abnormality diagnosed ante- or postnatally. the aim of this study was to determine the prevalence and severity of vesicoureteral reflux (vur) in neonates with antenatal or postnatal hydronephrosis and the value of ultrasono­graphy as a noninvasive tool for vur prediction.methods: in a prospective study, 202 infants with neonatal hydronephrosis were studied. two successive renal ultrasound examinations were performed at 1 and 4-6 weeks after birth in neonates with antenatal hydronephrosis or immediately after presentation. voiding cysto­urethrography (vcug) was performed in all infants.findings: the incidence of vur was 29.7%, of which 17.8% had severe (grade iv-v) reflux. 27% of 133 neonates with unilateral and 34.8% of 69 cases with bilateral hydronephrosis had vur. although a significant association was observed between severity of hydronephrosis and vur, 5.9% of normal appearing and 7.8% of grade 1 hydronephrotic neonates had high-grade reflux. conclusion: vur was observed significantly in hydronephrotic neonates. a normal or mildly hydronephrotic urinary tract on ultrasound scan cannot exclude presence of severe vur. we recommend performing vcug in all hydronephrotic newborns.