Is Evaluation with Voiding Cystourethrography Necessary for Children with a Febrile Urinary Tract Infection?.
- Author:
You Shin HA
1
;
Hong Jin SUH
;
Dong Hwan LEE
Author Information
1. Department of Urology, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Urinary tract infection;
Vesicoureteral reflux
- MeSH:
Child*;
Diagnosis;
Humans;
Retrospective Studies;
Succimer;
Technetium Tc 99m Dimercaptosuccinic Acid;
Ultrasonography;
Urinary Tract Infections*;
Urinary Tract*;
Vesico-Ureteral Reflux
- From:Korean Journal of Urology
2004;45(3):219-223
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In the diagnosis of pediatric urinary tract infection(UTI), the use of invasive methods, such as voiding cystourethrography(VCUG), is controversial. A retrospective study was carried out to evaluate the necessity for VCUG in assessing pediatric UTI. MATERIALS AND METHODS: Between April 2000 and March 2002, 70 children (60 boys, 10 girls) with symptomatic UTI were evaluated. All patients were evaluated with renal ultrasonography(RUS), 99mTc-DMSA renal scintigraphy(DMSA renal scan) and VCUG. The results of the VCUG were compared with RUS and similar comparisons made between the results of the VCUG and DMSA renal scans. Patients with both normal a RUS and DMSA renal scan were then evaluated for the frequency and grade of vesicoureteral reflux(VUR) on the VCUG. RESULTS: The mean age at the initial evaluation was 7.95 months, ranging from 1 to 52 months. RUS and DMSA scan abnormalities were found in 38(54.3%) and 26(37.1%) children, respectively. Of the 22 patients with VUR confirmed by VCUG, 11(50.0%) had an abnormal RUS, and 12 (54.5%) patients had abnormal DMSA renal scans. Of the 19 patients with both a normal RUS and DMSA scan, 4(21.2%, 6 kidney-ureter unit) were found to have VUR on VCUG. CONCLUSIONS: This study illustrated that a considerable number of patients may have significant VUR, despite normal renal ultrasonography and DMSA scans. Therefore, VCUG remains important in assessing pediatric UTI.
