Vesicoureteral reflux in boys: review of 196 cases

To determine the frequency of vesicoureteral reflux (VUR) in boys, the authors retrospectively studied 724 boys who underwent voiding cystourethrography for the first time. VUR was identified in 196 of these patients (27.0%). Urinary tract infection was the indication for cystourethrography in 188 patients (25.9%), 80 of whom (42.5%) had VUR. Hypospadias was the second most frequent indication (179 patients [24.7%]), with VUR present in 32 (17.8%). A significant frequency of VUR was demonstrated in boys studied for various other conditions. Excretory urography in 588 boys revealed congenital anomalies of the upper urinary tract in 72, with VUR in 26 (36.1%), which was significantly higher than that in boys with hypospadias (P greater than .01). There was no significant difference between the frequency of VUR in boys with hypospadias with or without meatal stenosis (P greater than .9) and in boys with meatal stenosis with or without hypospadias (P greater than .9); thus, VUR seems to be independent of mild urethral obstruction and hypospadias. VUR was more frequent in boys with posterior urethral valves (62.5%, P less than .002). VUR in boys with urinary tract infection is as common as in girls. In most cases, its frequency in many apparently unrelated conditions is suggestive of its primary nature.