ESPN 51th Annual Meeting

ESPN 2018


 
RETROSPECTIVE EVALUATION OF CHILDREN WITH PRIMARY VESICOURETERAL REFLUX
Selçuk Kıvılcım 1 Aslı Çelebi Tayfur 2 Aysun Çaltık Yılmaz 2 Bahar Büyükkaragöz 2 Mustafa Yordam 3 Ömer Faruk Bozkurt 3 MESUT KOÇAK 1

1- UNIVERSITY OF HEALTH SCIENCES, KEÇIÖREN TRAINING AND RESEARCH HOSPITAL, DEPARTMENT OF PEDIATRICS
2- UNIVERSITY OF HEALTH SCIENCES, KEÇIÖREN TRAINING AND RESEARCH HOSPITAL, DEPARTMENT OF PEDIATRIC NEPHROLOGY
3- UNIVERSITY OF HEALTH SCIENCES, KEÇIÖREN TRAINING AND RESEARCH HOSPITAL, DEPARTMENT OF UROLOGY
 
Introduction:

We evaluated the clinical characteristics and outcomes of children with primary vesicoureteral reflux (VUR) followed in a single medical center within the previous 5 years, retrospectively.

Material and methods:

 

We reviewed the patients’ records including demographic informations, physical examination findings, laboratory and imaging results, medical treatment and surgical treatment options.

Results:

Of 115 patients, 82,6% were females and 17.4% were males. The mean age at diagnosis was 57,22 ± 38,65 months. Sixty percent of the patients had recurrent urinary tract infections (UTI) and 17.4% of the patients had a family history of primary VUR. None of the patients had abnormal findings in physical examinations, hypertension or reduced glomerular filtration rate.  Lower urinary tract symptoms were found in the 62.6% of the patients. The voiding cystouretrography (VCUG) study demonstrated grade I-II VUR, grade III VUR and grade IV-V VUR in 26.8% (n: 40), 51.7% (n: 77) and 21.5% (n: 32) of 149 renal units, respectively. Renal parenchymal scarring were present in 50% of the patients who underwent 99mTc-DMSA scintigraphy. The presence of renal parenchymal scarring was significantly more common in patients with high grade VUR. The patients with renal parenchymal scarring were significantly more likely to have recurrent UTI and lower urinary tract symptoms. The patients with lower urinary tract symptoms were more likely to have recurrent UTI. Of 115 patients, 76 were put on antibiotic prophylaxis. Of 67 patients with control VCUG, 26 (38.8%) achieved spontaneous resolution and 36 (53.7%) underwent surgical intervention.

Conclusions:

Vesicoureteral reflux especially when together with lower urinary tract symptoms cause a predisposition to UTI and consequently renal parenchymal scarring. Patients with recurrent UTI and lower urinary tract symptoms should be evaluated for VUR. Diagnosis of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars.