Prevalence of Vesicoureteral Reflux in Children with Urinary Tract Infection Rasha Sulaiman Abd Al-Rahim* FIBS, Amal Abdulnabi Hussien** CABP, Riyadh M Al-Nassrawi*** MRCR, Sadek Hameed Ghani** CABP

  • imj Iraq Medical Journal
Keywords: Vesicoureteral Reflux, Urinary Tract Infection, Ultrasound, Voiding cystourethrography


Background: Vesicoureteric reflux is a frequent lower urinary tract abnormality observed in children with urinary tract infection. One to two percent of apparently healthy children have vesicoureteric reflux and it is observed in 30-40% of the children with urinary tract infection.

Objective: To determine the frequency of vesicoureteric reflux in patients with urinary tract infection and the association between demographic features, culture results, ultrasound findings, and severity of reflux.   Also, to highlight the causes of vesicoureteric reflux in those patients.

Methods: A retrospective review study was conducted at the department of nephrology at Central Child Teaching Hospital in Baghdad. Patients enrolled in this study aged from one month to 14 years .They were attending the nephrology department during the period from the 1st of January 2012 to 31stof December 2013 whom they undergone ultrasonography and voiding cystourethrography  after the diagnosis of urinary tract infection  had been settled.

Results: One hundred fifty patients with documented urinary tract infection were investigated for vesicoureteric reflux. The number of patients, who proved to have vesicoureteric reflux, was 52 (34.6%). The majority of cases diagnosed were below 5 years who were 41 (78.8%) patients, vesicoureteric reflux had diagnosed in 30 (57.7%) males and in 22 (42.3%) females. Twenty-two (42.3%) patients were diagnosed with vesicoureteric reflux after their first urinary tract infection, whereas 30(57.7%) patients after recurrent urinary tract infection. Primary vesicoureteric reflux is more to be diagnosed during first attack of urinary tract infection (53.8%) and secondary vesicoureteric reflux more to be associated with recurrent attacks of urinary tract infection (92.3%). Vesicoureteric reflux grades are distributed as follows: Grade I was 5 cases (9.6%), grade II; 5 cases (9.6%), grade III; 11case (21.2%), grade IV; 19 case (36.5%) and grade V; 12 case (23.1%). Abnormal urologic finding on abdominal ultrasound was abnormal in cases of vesicoureteric reflux 45 (86.5%). This ultrasound abnormality positively correlate with higher grades of vesicoureteric reflux.

Conclusion: vesicoureteric reflux is a frequent association in children with urinary tract infection even in first episode. Therefore, imaging studies like voiding cystourethrography is mandatory for detection of vesicoureteric reflux and its grading. 


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