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Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Post-pyelonephritic renal scars are not associated with high voiding pressures.

Seppo Taskinen1, Risto Rintala

  • 1Hospital for Children and Adolescents, Helsinki University, Stenbäckinkatu 11, 00290 Helsinki, Finland.

Journal of Pediatric Urology
|October 25, 2008
PubMed
Summary

Overactive detrusor is common after a child's first pyelonephritis. However, renal scars and vesicoureteral reflux (VUR) were not linked to this bladder dysfunction or high voiding pressures in the study.

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Area of Science:

  • Pediatric Nephrology
  • Pediatric Urology
  • Pediatric Infectious Diseases

Background:

  • First clinical pyelonephritis in children can lead to complications.
  • Bladder dysfunction may contribute to recurrent urinary tract infections (UTIs).

Purpose of the Study:

  • To investigate the association between renal scars, vesicoureteral reflux (VUR), and bladder dysfunction after a child's initial pyelonephritis episode.
  • To evaluate urodynamic findings in children post-pyelonephritis.

Main Methods:

  • Sixty-four children underwent urodynamics and voiding cystourethrography.
  • Renal scarring was assessed using dimercaptosuccinic acid (DMSA) scintigraphy during and after infection.
  • Vesicoureteral reflux (VUR) was evaluated via voiding cystourethrography.

Main Results:

  • Overactive detrusor was observed in 42% of children.
  • No significant association was found between renal defects on DMSA scintigraphy or VUR and overactive detrusor.
  • Maximal voiding pressure was higher in boys than in girls.

Conclusions:

  • Overactive detrusor is a frequent finding after the first pyelonephritis in children.
  • Bladder dysfunction may predispose some children to UTIs.
  • Urodynamic studies are not indicated as a primary investigation for children with pyelonephritis.