Unilateral vesicoureteral reflux detected by diuretic renography without voiding

Vesicoureteral Reflux in Nonfunctioning Renal Allograft Incidentally Detected in a Posttransplant 99mTc-DTPA Scan: Significance of Postvoid Imaging

ABSTRACT

In the present note, a case with rising serum creatinine shortly posttransplantation was referred for 99mTc-DTPA scan. The previous nonfunctioning renal allograft in the left hemipelvis showed no finding during dynamic phase of scan and filling phase of bladder but revealed a high-grade vesicoureteral reflux (VUR) in postvoid image, which can be responsible, partly, for the patient's present and prior symptoms.

Unexpected Vesicoureteral Reflux Into a Nonfunctioning Transplant Kidney on Renal Scintigraphy

Vesicoureteral reflux after renal transplantation is associated with increase risk of urinary tract infections, renal scarring, and graft failure. We describe a case of a 46-year-old woman with 2 transplant kidneys, one functioning and another nonfunctioning, presenting with pelvic pain after a bilateral periureteral bulking procedure. Diuretic renography was performed to exclude iatrogenic ureteral obstruction. This showed a normally functioning transplant kidney without obstruction and subsequent vesicoureteral reflux into the collecting system of the nonfunctioning transplant kidney. This inadvertent indirect nuclear cystogram illustrates an unusual imaging presentation of a common disease process requiring further treatment.

Vesicoureteral Reflux Detected on Post-void Image of (99m)Tc MAG3 Renal Scintigraphy

^99mTc MAG3 scintigraphic scan is sensitive at depicting focal parenchymal abnormalities and can be used for the measurement of overall renal function. We experienced a 5-year-old boy presenting with bilateral flank fain, intermittent urinary stream and dysuria. On the post-void delayed image of ^99mTc MAG3 scintigraphic scan vesicoureteral reflux was detected in left non-functioning kidney, which was missed on voiding cystourethrography.