Primary vesicoureteric reflux in Nepalese children

Vesicoureteric reflux (VUR) is a common urinary tract abnormality observed in children with urinary tract infection and children with VUR are at risk of reflux nephropathy and renal parenchymal damage. In Nepal, till date there are no published series of VUR in children.

To study the incidence of VUR in Nepalese children with Urinary tract infection (UTI), to analyze the age and sex wise distribution and clinical course of children with VUR together with the rate of spontaneous resolution of VUR in children

A retrospective hospital based study conducted at Department of Paediatrics Patan Hospital from June 2002 to December 2005. Hospital record files of all the children undergoing micturating cystourethrography (MCUG) as part of UTI work up were traced and the files of children with positive VUR were separated and analyzed.

Over the 3 and a half years study period total 145 micturating cystourethrograph were done in children with UTI, out of which 35(24%) were positive for VUR. Among the children with VUR, the most common age group was between two to twelve months and the male female ratio was 1.2:1.More than 60% had bilateral VUR and bilateral grade II VUR was the most common finding. Renal scan (DMSA) was done in only 5 cases and out of those two showed renal scaring. Eight cases underwent repeat MCUG after 1-1 1/2 years and spontaneous resolution of VUR was seen in 5 (62.5%) cases. Six cases were lost in follow up, 5 cases went for surgical intervention.

The incidence of VUR in children with UTI in our part is almost comparable to western data. Children with VUR need regular and long term follow-up.