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Paediatric urinary tract infection and the necessity of complete urological imaging

E J Kass1, K M Kernen, J M Carey

  • 1Department of Urology, Paediatric Division, William Beaumont Hospital, Royal Oak, MI 48073, USA.

BJU International
|July 25, 2000
PubMed

Insights

Voiding cysto-urethrography (VCUG) is crucial for diagnosing vesico-ureteric reflux (VUR) in children with urinary tract infections (UTI), even with normal ultrasounds and renal scans. Approximately 23% of children showed significant VUR in this study.

Area of Science:

  • Pediatric Nephrology
  • Diagnostic Imaging
  • Urology

Background:

  • Urinary tract infections (UTI) are common in children.
  • Renal scarring and vesico-ureteric reflux (VUR) are significant concerns.
  • Current guidelines recommend imaging to detect VUR.

Purpose of the Study:

  • To assess the utility of voiding cysto-urethrography (VCUG) in children with UTI.
  • To determine the prevalence of VUR when initial imaging is normal.

Main Methods:

  • Retrospective review of 468 renal scintigrams in children with UTI.
  • Analysis of renal/bladder ultrasonograms for children with normal renal scans.
  • Evaluation of VCUG for VUR in children with normal ultrasonography and renal scans.

Main Results:

  • 101 children had both normal renal scans and ultrasonograms.
  • 23% of these children (23/101) demonstrated VUR on VCUG.
  • 14 had bilateral VUR, and 13 had grade III or higher VUR.

Conclusions:

  • A significant percentage of children with UTI may have VUR despite normal renal scans and ultrasonography.
  • VCUG remains an essential diagnostic tool for evaluating VUR in pediatric UTI cases.
  • Early detection and management of VUR are critical to prevent renal damage.
Abstract

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