Vesical and Ureteral Damage from Voiding Dysfunction in Boys Without Neurologic or Obstructive Disease  Frank Hinman, Franz W. Baumann  The Journal of Urology  Volume 197, Issue 2, Pages S127-S131 (February 2017) DOI: 10.1016/j.juro.2016.10.098 Copyright © 2002 American Urological Association, Inc.® Terms and Conditions

Fig. 1 Barium enema shows typical distention of rectum by large fecal masses. The Journal of Urology 2017 197, S127-S131DOI: (10.1016/j.juro.2016.10.098) Copyright © 2002 American Urological Association, Inc.® Terms and Conditions

Fig. 2 A, voiding cystogram from boy with recurrent infection and wetting shows trabeculation in absence of outlet obstruction. B. IVP from same boy shows somewhat dilated and tortuous ureters and mild pyelonephritic changes. The Journal of Urology 2017 197, S127-S131DOI: (10.1016/j.juro.2016.10.098) Copyright © 2002 American Urological Association, Inc.® Terms and Conditions

Fig. 3 Case 1. A, initial IVP shows bilateral ureterovesical junction obstruction, with renal damage from back pressure and infection. B, initial voiding cystogram shows Christmas tree bladder and poorly filled urethra. C, initial barium enema shows large colon filled with boluses of fecal matter. The Journal of Urology 2017 197, S127-S131DOI: (10.1016/j.juro.2016.10.098) Copyright © 2002 American Urological Association, Inc.® Terms and Conditions

Fig. 4 Case 1, 1 year later. A, IVP shows reduction of obstruction. Infection had been cleared. B, normal barium enema The Journal of Urology 2017 197, S127-S131DOI: (10.1016/j.juro.2016.10.098) Copyright © 2002 American Urological Association, Inc.® Terms and Conditions

Fig. 5 Case 2. A, voiding cystogram shows upper tract damage, reflux and vesical trabeculation in absence outlet obstruction. B, IVP 1 year later suggests decreased back pressure. The Journal of Urology 2017 197, S127-S131DOI: (10.1016/j.juro.2016.10.098) Copyright © 2002 American Urological Association, Inc.® Terms and Conditions