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Infant vesicoureteral reflux: a comparison between patients presenting with a prenatal diagnosis and those presenting

John J Chen1, Jeff Pugach, Doug West

  • 1Department of Preventive Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, New York 11794-8036, USA.

Urology
|February 25, 2003
PubMed

Insights

Fetally diagnosed infant vesicoureteral reflux (VUR) is not predominantly male or high-grade. Few differences exist between fetally diagnosed and UTI-diagnosed infant VUR, with low morbidity and infrequent surgery needed for either group.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Medical Diagnostics

Background:

  • Infant vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder to the kidneys.
  • Commonly, VUR diagnosed prenatally (fetally) is believed to be more severe, affecting males more often, and being bilateral.
  • This study investigates the characteristics and outcomes of VUR diagnosed prenatally versus post-urinary tract infection in infants.

Purpose of the Study:

  • To compare the severity, laterality, and gender distribution of infant VUR based on diagnosis timing (prenatal vs. post-UTI).
  • To evaluate the impact of VUR diagnosis timing on renal outcomes, including scarring and need for surgery.
  • To challenge common assumptions about the characteristics of fetally diagnosed VUR.

Main Methods:

  • Retrospective review of 202 infants diagnosed with VUR before six months of age.
  • Comparison of VUR grade, gender, laterality, initial renal scarring, subsequent UTIs, new scarring, and surgical intervention between fetally diagnosed (FDR) and UTI-diagnosed (INF) groups.
  • Statistical analysis to determine significant differences between the two groups.

Main Results:

  • The male/female ratio differed significantly, with more males in the FDR group (1.67:1) compared to the INF group (0.60:1).
  • The FDR group showed a higher incidence of unilateral VUR (P <0.001).
  • No significant differences were found in VUR grade distribution, initial renal damage, or clinical course between the groups.

Conclusions:

  • Findings do not support the belief that fetally diagnosed VUR is predominantly male, bilateral, and high-grade.
  • Minimal differences were observed between infants diagnosed prenatally and those diagnosed after a UTI.
  • Infant VUR, regardless of diagnosis timing, generally has low morbidity and infrequent need for surgical intervention.
Abstract

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