title: VURD syndrome managed by pyelostomy.
abstract: We report a case of VURD syndrome in a three day old neonate who was diagnosed with hydronephrosis on a prenatal ultrasound. Severe tortuosity and dilation of the upper urinary tracts in the presence of progression of hydronephrosis or a persistently elevated creatinine may favor a proximal urinary diversion rather than primary valve ablation or cutaneous vesicostomy. Because of a persistently elevated serum creatinine, a nonfunctioning kidney with grade 4/5 vesicoureteral reflux and worsening contralateral hydronephrosis despite lower tract drainage, a left cutaneous pyelostomy was performed, contralateral to the kidney involved with VURD. Postoperatively the serum creatinine stabilized at 1.0 mg/dl and decreased to 0.3 mg/dl at one month of age.
authors.affiliation: Department of Urology, Bowman Gray School of Medicine Wake Forest University, Winston-Salem, North Carolina, USA.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Rosser
authors.forename: Sam
authors.initials: S
authors.lastname: Auringer
authors.forename: R Lawrence
authors.initials: RL
authors.lastname: Kroovand
mesh_terms: D000328:Adult; D003401:Creatine / Q000652:urine; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities; D007682:Kidney Pelvis / Q000601:surgery*; D016104:Oligohydramnios / Q000000981:diagnostic imaging; D011247:Pregnancy; D011859:Radiography; D013577:Syndrome; D016216:Ultrasonography, Prenatal; D014521:Urethra / Q000002:abnormalities / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D014551:Urinary Tract / Q000002:abnormalities*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D003401:Creatine