بررسي شيوع برگشت ادرار از مثانه به حالب در كودكان مبتلا به عفونت ادراري علامت دار

PREVALENCE OF VESICOURETERAL REFLUX IN CHILDREN WITH SYMPTOMATIC URINARY TRACT INFECTIONS

Urinary tract infection (UTI) is one of the most common bacterial infections in children. UTI may be a presentation of urinary tract abnormality including vesicoureteral reflux (VUR) in about 29-50% of children with symptomatic UTI. The long-term complications of UTI with this condition is renal scarring, hypertension and chronic renal failure. During a two year period, 158 patients admitted with symptomatic UTI aged 1 month up to 15 years, VUR was diagnosed by voiding cystourethrography (VCUG) and the patients were followed up for 6 to 24 months. Among the 158 cases, 126 patients were selected for this study (100 girls and 26 boys). There were 77% under 5 years. The most common symptoms were fever without localizing sign and dysuria. VUR was detected in 39.6% of patients (39% of girls, 42.3% of boys). There were 25.39% unilateral and 14.2% bilateral. Symptomatic UTIs were more common in girls (88%) and younger children (77% < 5 years). Forty percent of these patients had VUR in which 14% were bilateral. Symptomatic UTI may be a presentation of an underlying problem particularly VUR that may be severe and bilateral. For this reason, VCUG should be performed in any patient in every age and sex. Furthermore, ultrasonographic studies of kidney and the urinary tract (for detection of underlying abnormality) and renal cortical scan (3-6 months later) for evaluation of renal scarring are required.