Occurrence of vesicoureteral reflux in children

• Published in: Acta Paediatrica Vol. 99; no. 12; pp. 1875 - 1878
• Main Authors: Venhola, M, Hannula, A, Huttunen, N-P, Renko, M, Pokka, T, Uhari, M
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2010; Blackwell
• Subjects: Bacterial diseases; Bacterial diseases of the urinary system; Biological and medical sciences; Child; Child, Preschool; Female; General aspects; Human bacterial diseases; Humans; Imaging; Incidence; Infant; Infectious diseases; Kidney; Male; Medical sciences; Nephrology. Urinary tract diseases; Practice Guidelines as Topic; Referral and Consultation; Reproducibility of Results; Retrospective Studies; Urinary system involvement in other diseases. Miscellaneous; Urinary Tract Infections - diagnosis; Urinary Tract Infections - epidemiology; Urinary tract. Prostate gland; Urinary-tract infection; Vesico-Ureteral Reflux - epidemiology; Vesicoureteral reflux; Human; Pediatrics; Urinary system disease; Urinary-tract infection; Urinary tract disease; Kidney; Urinary tract infection; Urinary system; Vesicoureteral reflux; Imaging; Medical imagery; Bladder disease; Child
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2010.01909.x

Aim:  The reported low occurrence of vesicoureteral reflux in the general population seems implausible. We wanted to test the hypothesis that reflux is more common and more independent of urinary‐tract infection than has previously been thought. Methods:  We tested our hypothesis by analysing the characteristics of 406 consecutive children aged <5 years who had been referred for consultation because of urinary‐tract infection. Using data on their urine samples, we evaluated the reliability of the urinary‐tract infection diagnosis and analysed the frequencies of vesicoureteral reflux and abnormal ultrasound findings in three reliability groups (A: certain urinary‐tract infection, B: possible and C: improbable). Results:  The occurrence of reflux was the same irrespective of the diagnostic reliability of urinary‐tract infection (A: 98/276 [36%] versus B: 13/46 [28%] versus C: 9/25 [36%]). Most of the abnormal ultrasound findings (58/71, 80%) were found among patients with a certain diagnosis (Group A). Conclusion:  We suggest that vesicoureteral reflux is more common in children even without urinary‐tract infection than has been thought previously. The guidelines recommending a search for reflux by means of voiding cystourethrography should be reconsidered.