3-year-old female with left cutaneous ureterostomy takedown and reimplantation 10/04/16. History of cloacal reconstruction, left solitary kidney with obstructing megaureter with left pyeloplasty. Assess for possible improvement in dilation of bladder and left upper tracts. BLADDER  Wall Thickness: Moderate wall thickening.  Contents: There is slight decrease in the debris within the bladder, with the bladder appearing slightly more decompressed as compared to prior exam. Distal Ureter -- SFU Grade**  Left: 0 , no significant ureter dilatation is observed on this exam.   Ureteral Jets  Left: Not observed LEFT KIDNEY  Cortical Echogenicity: Normal   Medullary Echogenicity: Normal   Pelvicaliceal System -- SFU Grade*  Left: 3, small amount of debris is identified within the left renal pelvis. Dilatation of the renal pelvis measures 2.5 cm anteroposteriorly, as compared to 2.8 cm on the prior exam.   Length*** Left: 8.4 cm   Mean for age: 7.3 cm  Range for age: 6.1 - 8.1 cmADDITIONAL OBSERVATIONS: No significant abnormalities noted
Persistent left hydronephrosis with debris in the renal pelvis and bladder. Ureteral dilatation is no longer visualized.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469