Can ultrasonography or uroflowmetry predict which children with voiding dysfunction will have recurrent urinary tract...

Area of Science:

• Pediatric Urology
• Nephrology
• Diagnostic Imaging

Background:

• Incomplete bladder emptying in children with voiding dysfunction is suspected to cause recurrent urinary tract infections (UTIs) and kidney damage.
• Bladder-sphincter dyssynergia may underlie poor bladder emptying.
• Ultrasonography and uroflowmetry are standard initial assessments for pediatric voiding dysfunction.

Purpose of the Study:

• To investigate the role of incomplete bladder emptying in the development of UTIs in children with voiding dysfunction.
• To determine if abnormal ultrasonography or uroflowmetry can predict which children are at higher risk for recurrent UTIs.

Main Methods:

• Retrospective cohort study of 148 patients with diagnosed voiding dysfunction.
• Review of patient charts for post-void residual urine volumes (ultrasound) and subsequent UTI occurrences.
• Blind reevaluation of initial uroflowmetry curves.

Main Results:

• 15% of ultrasounds showed significant post-void residual urine volumes (>10% predicted).
• 78% of uroflowmetry studies were abnormal.
• Age-corrected residual urine volume positively correlated with subsequent UTI frequency (r=0.3, p<0.002).
• No correlation found between abnormal uroflowmetry patterns and subsequent UTIs.

Conclusions:

• Elevated post-void residual urine on ultrasound increases UTI recurrence risk in children with voiding dysfunction.
• However, this finding does not enable precise identification of individual children at high risk for recurrent UTIs.