Pseudoreflux and detrusor overactivity due to accidental ureteral catheterization during cytometry in a pediatric patient |
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| Institution: | 1. Pediatric Uronephrologic Center, The Queen Silvia Children''s Hospital, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;2. The Children''s Memorial Health Institute, Warsaw, Poland;1. Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA;2. Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA;1. Department of Radiology and Research Institute of Radiological Science, Severance Children''s Hospital, Yonsei University College of Medicine, 120-752 Seoul, Republic of Korea;2. Department of Pediatric Urology, Severance Children''s Hospital, Yonsei University College of Medicine, 120-752 Seoul, Republic of Korea;3. Biostatistics Collaboration Unit, Yonsei University, College of Medicine, 120-752 Seoul, Republic of Korea;1. Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Ontario, Canada;2. Center for Computational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada;3. Division of Pediatric Urology, UH Rainbow Babies and Children''s Hospital, Cleveland, OH, USA;4. Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada;1. Department of Obstetrics, Academic Medical Center AMC, Amsterdam, The Netherlands;2. Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia;3. Department of Pediatric Nephrology, Emma Children''s Hospital/Academic Medical Center, Amsterdam, The Netherlands;1. Nephrology and Hypertension, Children''s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA;2. Division of Pediatric Urology, Oregon Health & Science University, Portland, OR, USA;3. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;4. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA;5. Department of Pediatrics, University of Pittsburgh School of Medicine, Children''s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA;6. Department of Urology, Johns Hopkins School of Medicine, Baltimore, MD, USA;7. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA;8. Division of Pediatric Urology, Women & Children''s Hospital of Buffalo, State University of New York at Buffalo School of Medicine & Biomedical Sciences, Buffalo, NY, USA |
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| Abstract: | We present the case of a 9-year-old girl with a neurogenic bladder who had accidental ureteral cannulation with the vesical catheter during cytometry. This is the first reported pediatric case described of this complication, the four prior cases all being in adults. The signs and symptoms of ureteral catheterization differed significantly in this patient from the adult cases. In our patient, malpositioning of the vesical catheter yielded a misleading pressure profile of primarily rhythmic pressure increases suggestive of severe detrusor overactivity and vesicoureteral reflux on fluoroscopy. The reading, however, actually reflected ureteric filling and peristalsis, and these findings resolved when the catheter was properly repositioned. This case highlights the possibility of inadvertent ureteral catheterization, and that, while rare, this complication should be kept in mind when new or unexpected DO or VUR is observed upon filling cystometry. |
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