Prune belly ultrasonography

Diagnostic criteria of the prune belly phenotype are wrinkled skin, thinness, and laxity of the abdominal wall (Fig. 17.1) in the absence of palpable testes. Urinary tract abnormalities are demonstrable only by diagnostic procedures, e.g., ultrasonography, and vary widely in appearance and severity. 

After the physical examination has been completed, ultrasonography should be performed. A realistic interpretation of an ultrasound examination is important since it provides only anatomic information dilatation of the urinary trart is not necessarily induced by obstruction, particularly in patients with prune belly syndrome. In addition to dilatation of the renal pelvis and the ureter, bladder filling and bladder wall thickness can be determined by ultrasound (Fig. 17.3). Bladder outlet obstruction is usually associated with... 

In prune belly syndrome the degree of urinary tract involvement varies. Observation with selective surgical intervention is currently the most popular therapy. Patients require regular assessment using ultrasonography and radionuclide renal function studies. 

Fig. 18.15a-c. Boy with prune belly syndrome, a There is significant dilatation of the collecting systems and ureters (arrow), b Ultrasonography shows echogenic bladder content. c CT shows outlining of thickened bladder wall due to bladder infection as a result of poor emptying... 

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