PMC3754402_01
Figure 1: Voiding cystourethrography; (a) before transurethral incision of the valves, (b) before left nephroureterectomy, (c) 7 months after nephroureterectomy
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F1
Voiding cystourethrography and diuretic renography revealed that he had VURD syndrome (Fig. 1a). On postoperative voiding cystourethrography, the unilateral reflux remained unchanged although the bladder outlet obstruction was relieved (Fig. 1b). After one year, clean intermittent catheterization and anticholinergic drugs were discontinued because he had neither voiding nor storing problems on video urodynamic study (Fig. 1c).
PMC3754402_02
Figure 2: Voiding cystourethrography; (a) before transurethral incision of the valves, (b) before right nephroureterectomy, (c) before restart of anticholinergic drugs, (d) After restart of anticholinergic drugs
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F2
Voiding cystourethrography and diuretic renography revealed that he had VURD syndrome (Fig. 2a). The unilateral reflux remained unchanged on postoperative voiding cystourethrography (Fig. 2b). The bladder compliance was 10 ml/cm H2O on video urodynamic study (Fig. 2c). At 8 year of age, the bladder compliance increased to 30 ml/cmH2O on video urodynamic study (Fig. 2d).
PMC3754402_03
Figure 3: Voiding cystourethrography; (a) before transurethral incision of the valve, (b) before left nephroureterectomy, (c) 6 months after nephroureterectomy. Bladder trabeculation growing worse.
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F3
Voiding cystourethrography and diuretic renography revealed VURD syndrome (Fig. 3a). The unilateral reflux remained unchanged on postoperative voiding cystourethrography (Fig. 3b). At 10 years of age, the bladder compliance was 17 ml/cm H2O on video urodynamic study (Fig. 3c).