Vesicoureteral reflux in adults

Area of Science:

• Urology
• Radiology

Background:

• Vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder to the ureters.
• Diagnosing VUR in adults can be challenging, especially in the absence of active urinary tract infections (UTIs).

Purpose of the Study:

• To evaluate the diagnostic utility of excretory urography in detecting vesicoureteral reflux in adults.
• To determine the association between recurrent UTIs and urographic findings suggestive of VUR.

Main Methods:

• Retrospective analysis of 200 adult patients diagnosed with VUR over a 4-year period.
• Review of excretory urograms and patient histories, including UTI history and urine culture results.
• Correlation of urographic findings (renal scarring, ureteral dilatation, mucosal striations) with VUR diagnosis.

Main Results:

• All patients without a UTI history but with VUR showed abnormalities on excretory urograms.
• In patients with recurrent UTIs, excretory urograms were abnormal in 79% (negative cultures) and 83% (positive cultures).
• Urographic findings suggestive of VUR were present even in asymptomatic patients.

Conclusions:

• Vesicoureteral reflux should be suspected in adults with recurrent UTIs, irrespective of current urine culture status.
• Abnormalities on excretory urography, such as renal scarring or ureteral dilatation, warrant suspicion for VUR.
• Voiding cystourethrography is recommended for all adult patients with suggestive urographic findings to confirm or exclude VUR.