Indian Journal of Urology
ORIGINAL ARTICLE
Year
: 2014  |  Volume : 30  |  Issue : 4  |  Page : 383--386

Practical approach to screen vesicoureteral reflux after a first urinary tract infection


Maria Alvarez Fuente, Talia Sainz Costa, Begona Santiago Garcia, Marcelina Algar Serrano, Manuel Sosa Alonso, Esther Aleo Lujan 
 Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain

Correspondence Address:
Maria Alvarez Fuente
Avenida de Valladolid 71 1°D, 28008 Madrid
Spain

Introduction: Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (RUS). Voiding cystourethrography (VCUG) and dimercaptosuccinic acid (DMSA) scan are the other main radiologic studies used to detect VUR. We evaluated the use of RUS as a screening method for VUR in children below 2 years of age, in order to avoid unnecessary VCUG. Materials and Methods: Medical records and imaging studies of infants (<2 years) who had their first UTI in a 6 year period were retrospectively reviewed. We evaluated the sensitivity, specificity, and negative predictive values of RUS and DMSA for diagnosing VUR. Results: Among 155 children (51% males) with their first UTI, 148 RUS were performed, 128 VCUG and 29 DMSA. VUR was detected in 21% patients; 14.5% low grade and 6.5% high grade. One hundred and twenty-one patients underwent both RUS and VCUG, 101 RUS were normal and 20 abnormal. Of the normal RUS 98% had no or low grade VUR. Among those with an abnormality on RUS 30% had high grade VUR (P = 0.001). Conclusions: After the first UTI in infants (<2 years) RUS is a good screening method for VUR. Among such shildren with a normal RUS, we do not recommend VCUG or DMSA. In our opinion, VCUG should be performed only in patients with abnormal findings in RUS or in recurrent UTI.


How to cite this article:
Fuente MA, Costa TS, Garcia BS, Serrano MA, Alonso MS, Lujan EA. Practical approach to screen vesicoureteral reflux after a first urinary tract infection .Indian J Urol 2014;30:383-386


How to cite this URL:
Fuente MA, Costa TS, Garcia BS, Serrano MA, Alonso MS, Lujan EA. Practical approach to screen vesicoureteral reflux after a first urinary tract infection . Indian J Urol [serial online] 2014 [cited 2021 Sep 17 ];30:383-386
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2014;volume=30;issue=4;spage=383;epage=386;aulast=Fuente;type=0