[Severe bilateral vesicoureteral reflux and nephropathy in male newborns: valve-like syndrome or uncoordinated voiding in the male fetus].
Various papers differentiating neonatal vesicoureteral reflux (VUR) with severe renal damage from other predominant group of newborns with neonatal VUR without renal lesions and those diagnosed in older ages, generally in relation with urinary tract infection (UTI), have been published over the last decade. From the standpoint that VUR is part of a broad spectrum both in clinical expression as in pathogenesis, with different theories described to explain the existence of this type of congenital VUR in males. The existence of a fetal vesicourethral dysfunction, presenting after birth as a high risk bladder, which is defined by urodynamic tests in the first trimester, explains the appearance of severe fetal VUR with functional deterioration of one or both renal units at the time of birth; this entity must be diagnosed to establish the adequate therapeutic management. This clinical picture is named Valve like syndrome or male uncoordinated fetal voiding.
Luque Mialdea
Rafael
R
Urología Pediátrica, Servicio de Cirugía Pediátrica, Complejo Hospitalario de Toledo, Toledo, España. rluque@sescam.jccm.es
Martín-Crespo
Rosa
R
D005333:Fetus / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D012720:Severity of Illness Index; D014555:Urination Disorders / Q000209:etiology*; D014718:Vesico-Ureteral Reflux / Q000150:complications*