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Findings in cystourethrography that suggest lower urinary tract dysfunction in children with vesicoureteral reflux

Ubirajara Barroso1, Antonio J Vinhaes, Milton Barros

  • 1Section of Pediatric Urology, San Rafael Hospital, Federal University of Bahia, Salvador, Bahia, Brazil. ubarroso@uol.com.br

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|January 25, 2005
PubMed

Insights

Many children with lower urinary tract dysfunction and vesicoureteral reflux show anatomical changes on voiding cystourethrography (VCUG). These findings suggest dysfunction in most cases, with higher-grade reflux associated with positive VCUG results.

Area of Science:

  • Pediatric Urology
  • Radiology
  • Pediatric Nephrology

Background:

  • Lower urinary tract dysfunction (LUTD) and vesicoureteral reflux (VUR) are common in children.
  • Anatomical alterations like posterior urethral dilation and bladder diverticula are frequently observed during cystography in these patients.
  • The clinical significance of these anatomical findings in VUR patients remains unclear.

Purpose of the Study:

  • To determine the incidence of anatomical abnormalities suggestive of LUTD in children with VUR.
  • To assess the resolution rate of these anatomical findings over time.
  • To correlate the presence and persistence of these findings with the severity of vesicoureteral reflux.

Main Methods:

  • Analysis of 193 children diagnosed with simple VUR, aged over 5 years.
  • Inclusion criteria required a minimum of two voiding cystourethrograms (VCUGs) performed at least 6 months apart.
  • VCUGs were categorized as positive or negative for findings indicative of LUTD.

Main Results:

  • Out of 193 children, 50 (26%) had positive VCUG findings, while 143 (74%) had negative findings.
  • Among patients without LUTD symptoms (n=135), 9% had positive VCUGs.
  • A statistically significant association was found between higher-grade reflux (Grade III) and positive VCUG findings suggestive of LUTD (p < 0.05).

Conclusions:

  • A significant proportion of children with LUTD and VUR exhibit VCUG findings suggestive of dysfunction.
  • These anatomical changes on VCUG may indicate underlying lower urinary tract issues in pediatric VUR patients.
  • The study highlights the importance of evaluating VCUG for anatomical abnormalities in children with VUR.
Abstract

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