Abstract

Introduction: In this study, we evaluated the vesico-ureteric reflux (VUR) in renal transplant recipients by

using color Doppler urosonography (CDU).

Materials and Methods: Among 149 renal transplant recipients, 42 (27 men, 15 women) who accepted to

take part were included to the study. The mean age and duration of post-transplant follow-up of the patients

were 35.1±1.39 years (15-55) and 63.6±7.2 months (7-170), respectively. In all patients, ureterovesical

anastomosis and antireflux submucosal tunnel were performed with Lich-Gregoir technique without using

ureteral stent. Urinary system was assessed in all patients with CDU without any contrast enhancing agent by

the same radiologist. During CDU, patients were asked to make Valsalva maneuver when their bladders were

full with urine and were evaluated for reflux. The patients’ ureteric jets were first investigated in transverse

and then in longitudinal plane by observing distal ureteric segment and ureteral orifice. The flows coming

towards the transducer were coded red in color while those moving away from the transducer were coded blue

in color. During observation of the distal ureteric segment; detection of red color was regarded as reflux. The

patients, in whom reflux was detected by CDU, were reassessed by voiding cystouretrography (VCUG).

Results: Among 42 patients who underwent CDU, 7 patients (16.7%) were diagnosed to have VUR. In all

patients, the diagnosis of CDU detected VUR was confirmed by VCUG. In 4 patients (57.2%) low grade and in

3 patients (42.9%) intermediate grade reflux was found by using CDU. None of the patients had high grade

reflux. In 3 patients (42.9%) grade 2, in 3 patients (42.9%) grade 3, in 1 patient (14.2%) grade 4 reflux were

observed during evaluation of these patients by VCUG. Since VCUG is an invasive procedure and the patients

who were determined not to have VUR by CDU had no urinary tract infection history in the follow-up they did

not undergo VCUG.

Conclusion: CDU is a non-invasive and effective method for the diagnosis and follow-up of VUR in renal

transplant recipients.