Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

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Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

This calculator interprets voiding cystourethrogram findings based on the International Reflux Study Committee grading system for vesicoureteral reflux. The interpretation is determined by examining the extent and severity of reflux as observed in the ureters, pelvis, and calyces, according to specific descriptions.

The input is gathered by selecting one of the predefined options for voiding cystourethrogram findings, each corresponding to a different level of reflux and structural changes:

1. Reflux into the ureter only
2. Reflux into the ureter, pelvis, and calyces; absence of dilatation; normal calyceal fornices
3. Mild or moderate dilatation and/or tortuosity of the ureter; mild or moderate dilatation of the renal pelvis; no or slight blunting of the fornices
4. Moderate dilatation and/or tortuosity of the ureter; moderate dilatation of the renal pelvis and calyces; complete obliteration of the sharp angle of the fornices; maintenance of the papillary impressions in the majority of calyces
5. Gross dilatation and tortuosity of the ureter; gross dilatation of the renal pelvis and calyces; the papillary impressions no longer visible in the majority of the calyces

The calculator processes these inputs to classify the reflux into one of the five grades:

| Voiding Cystourethrogram Findings                                     | Result  |
|-----------------------------------------------------------------------|---------|
| Reflux into the ureter only                                           | Grade I |
| Reflux into the ureter, pelvis, and calyces; absence of dilatation; normal calyceal fornices | Grade II |
| Mild or moderate dilatation and/or tortuosity of the ureter; mild or moderate dilatation of the renal pelvis; no or slight blunting of the fornices | Grade III |
| Moderate dilatation and/or tortuosity of the ureter; moderate dilatation of the renal pelvis and calyces; complete obliteration of the sharp angle of the fornices; maintenance of the papillary impressions in the majority of calyces | Grade IV |
| Gross dilatation and tortuosity of the ureter; gross dilatation of the renal pelvis and calyces; the papillary impressions no longer visible in the majority of the calyces | Grade V |

If none of the conditions match the predefined findings, the system returns a prompt to select an input for evaluation. Users are required to make a selection that aligns with their findings to receive a proper grading result.

The calculator in question is the International Reflux Study Committee (IRSC) grading of vesicoureteral reflux. This grading system is used in the pediatric population, specifically in children who have been diagnosed with vesicoureteral reflux (VUR), a condition where urine flows backward from the bladder into the ureters and kidneys. 

The IRSC grading system is a clinical tool used to classify the severity of VUR. It ranges from Grade I (mild) to Grade V (severe), based on the extent of the reflux and the presence of any renal abnormalities. This grading system helps clinicians to determine the appropriate treatment strategy and to predict the patient's prognosis. 

There are no specific exclusion criteria for the use of the IRSC grading system. However, it is important to note that this grading system is only applicable to patients who have been diagnosed with VUR. It is not used to diagnose the condition itself.

Vesicoureteral reflux

Guidelines

Key sources