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Contemporary videourodynamic (VUD) investigation combines voiding cystourethrography (VCUG) and urodynamics into one study, which allows simultaneous visualization of the urinary tract by ionizing radiation alongside the measurement of sensation, capacity, compliance, and detrusor pressure during bladder filling and voiding using one double lumen catheter. Today VUD is a benchmark for evaluating the lower urinary tract disorders in children because it evaluates urinary bladder and sphincter function and visualizes bladder morphology and vesicoureteral reflux (VUR) presence at the same time. Several previous studies of fluoroscopic videourodynamics issued concerns regarding radiation exposure. This technical report aims to describe a new modality of VUD in children by replacing fluoroscopic VCUG with contrast-enhanced voiding urosonography (ceVUS). ceVUS using second-generation contrast media and harmonic imaging is a radiation-free and highly sensitive imaging modality used to detect VUR in children. We simultaneously performed an infusion of ultrasound contrast through the double lumen urodynamic catheter during urodynamic evaluation. This article describes the advantages of this method compared with a conventional technique. In addition to being radiation-free, this procedure of advanced videourodynamics method can better detect vesicoureteral reflux and intrarenal reflux combined with urodynamic disorders associated with VUR.

Purpose: Although contrast-enhanced urosonography (ceVUS) has shown capable diagnostic accuracy for the diagnosis of vesicoureteral reflux (VUR) in children, the ability of ceVUS to detect intrarenal reflux (IRR) is considered limited. The purpose of our study is to assess the ability of ceVUS to detect IRR as well as its association with age, gender, and the grade of VUR. Methods: This study included 5153 children who were referred to our clinic for ceVUS. All children underwent sonographic examinations, which were performed on a LOGIQ S8 machine equipped with dedicated software for contrast-enhanced studies with harmonic imaging. Standard ultrasound of the urinary tract was followed by bladder catheterisation and instillation of physiological normal saline and the US contrast medium (SonoVue®, Bracco). Results: VUR was diagnosed by ceVUS in 1959 out of 5153 children (38%), of whom IRR was found in 233 of 1959 children (11.9%). A total of 285 ureteral units showing IRR were found. High grades of VUR (IV + V) with IRR were found in a total of 235 of 285 (82.81%) renal units. Bilateral IRR was found in 53 patients, usually with a high-grade VUR on both sides. Most children had VUR grade IV, predominantly those < 12 months. The younger the child, the higher the likelihood of higher-grade VUR (p = 0.02). Conclusion: ceVUS, combined with harmonic imaging and second-generation ultrasound contrast media, enabled IRR detection in almost 12% of our patients with VUR. IRR is most commonly found in children under 1 year of age with VUR grades IV and V.

Child with rare urinary tract anomaly is presented.

Results of study about sociodemographic and neurodevolepmental factors in primary monosyptomatic nocturnal enuresis (PMNE) differ in different cultural groups. The aim of this study was to research factors associated with (PMNE) in the clinical sample of Croatian children. Parents of children with diagnose of PMNE (50 children aged 7–11 years) which are treated at University Department of Psychiatry in Osijek and 50 children of same age without nocturnal enuresis (CG) randomly selected from primary school in Osijek completed the self-administred questionnaire. Data collection included information about most important sociodemographic and neurodevolpmental factors associated with PMNE. Differences between study group in investigated factors and relationship between the prevalence of PMNE enuresis and the sociodemographic and neurodevolpmental factors were tested by means of χ2 and logistic regression analysis. Significant differences between groups were found in following sociodemographic and neurodevolopmental factors: family structure, parent's marital status, father's and mother's education, parents' employment status, average monthly income per family member, living conditions, number of children in family, family history of enuresis, pregnancy complications and age of reaching diurnal continence. When logistic regression was applied altered the primary structure of marriage (illegitimate, divorced, widowed, parent's death), unemployment of parents, low average monthly income per family member ( The results show that PMNE requires individualized approach to treatment where influence of sociodemographic and neurodevelopmental factors has a significant role.