Featuring: Distal ureteral diameter in the resolution of vesicoureteral reflux.
In April the Pediatric Urology Journal Club (PUJC) discussed validation of the ureteral diameter ratio (UDR) for predicting resolution of primary vesicoureteral reflux (VUR) [1]. Authors Angela Arlen (@angelaarlen), Andrew Kirsch (@drandrewkirsch), and Christopher Cooper (@coopeduro) participated. The authors briefly explained UDR and the rationale for using it over VUR grade. Ureteral diameter is measured as the largest diameter in the false pelvis. UDR is calculated by dividing ureteral diameter by the distance from L1 to the top of L3, which controls for patient size and radiographic magnification. The authors have previously shown UDR to be more objective, reproducible (with higher inter-rater reliability), and predictive of VUR resolution than grade [2e4]. In their most recent paper, the authors found UDR was more predictive of early spontaneous resolution than grade alone.