V.F. Peterburgskyy, V.V.Golovkevich, G.I. Guyvan

The echographic markers of urodynamics decompensation in nonrefluxing megaureters in infants

The echographic markers of urodynamics decompensation in nonrefluxing megaureters in infants were analyzed in terms of their diagnostic informational value ( sensitivity, specifity, positive and negative predictive values) in 62 infants with nonrefluxing megaureters assumed as decompensated. The ureteral contractions incidence per minute and ureteral diameter were the parameters estimates. The decompensation risk of the upper urinary flow was estimated using the 2x2 tables. The difference between proportions was estimated using c2 or exact Fisher test. The ureteral contractions incidence less than 4 per minute is attributive to the high risk (8,46; 95% CI 2,6984-34,4802) of the upper urinary flow decompensation with 81% sensitivity, 82% specifity, 62% positive predictive value and 93%. negative predictive value. It was shown that in cases with ureteral diameter more than 2 cm the urinary flow decompensation is 14,7 fold higher than in lesser ureteral diameter cases (RR 5,82 ; 95% CI 2,23-15,44) with 69 % sensitivity, 87% specifity, 65% positive predictive value and 89%. negative predictive value. The ureteral contractions incidence less than 4 per minute ureteral diameter more than 2 cm could be utilized as additional markers of the ureteral decompensation in infants with megaureter. These results shioud be taken into account whilst choosing the management tactics because the decompensated ureteral contractility limits the radical correction and make us facing the staged reconstruction.