INCIDENCE OF VESICOURETERIC REFLUX IN CHILDREN WITH URINARY TRACT INFECTION AND METHODS OF MANAGEMENT

Abstract

Background:many studies demonstrated a correlation between reflux and chronic pyelonephritis in paraplegic individuals
and a correlation among urinary tract infection (UTI), reflux, and chronic pyelonephritis in children, which suggested that
prevention of vesicoureteral reflux may result in reduced prevalence of renal complications. The subsequent developments
in the medical and surgical management of vesicoureteral reflux formed the basis of the evolving field of pediatric urology.
Aim of work:The aim of this study was to study the epidemiology of urinary tract infection and congenital vesicoureteric
reflux in Sharkia Governorate including prevalence & management.
Subjects and methods: descriptive case series study was done The study population includes all patients came to pediatric
surgery department pediatric urology & pediatric outpatient clinic in zagazig university hospitals from feb 2011 to feb
2012.All studied group subjected to:1- History taking & complete clinical examination, including:Name, age, sex, Locality,
telephone number and symptoms to determine the symptomatic condition that associated with UTI & VUR.2- URINE
analysis :All patients were subjected to complete urine analysis: Physical, chemical & microbiological , Either mid stream
collection or using catheterization under complete a septic condition or using clean sterile bags.3- Urine culture: Sensitivity
for all cases with UTI to all antimicrobial. 4-Renal ultrasound: Was done for all cases of UTI to detect renal complication.5-
Voiding CystoUretrogram (V.C.U.G) :Was done for cases of suspected VUR by ultrasound.6-Grading of patients of VUR
into 3 group according to the grade A grade(I & II),B grade (III) and C grade (IV & V). 7- Follow up the treatment of all
cases regarding their grades.This study showed that there is significant association between age and UTI presence and the
percentage of UTI in children <5 (16.6%) shows that there is no significant association between Respiratory symptoms &
UTI . shows that there is significant association between GIT symptoms and UTI as 28.9% of UTI cases had GIT
symptoms. shows that there are 32 cases of VUR among 190 cases of UTI (16.8%) from UTI cases & (2.1%) from all
studied group.shows that there were 3 main group of VUR Group (A) include Grade I & II , Group (B) include Grade III
and Group (C) include Grade IV& V distributed between two categories as unilateral and bilateral.shows that 100% of
group (A) were medical &100% of group (C) were surgical while in group (B) there were about 58% medical & 42%
surgical.
Conclusion:It can be concluded from this study that there are 32 cases of VUR among 190 cases of UTI (16.8%) from UTI
cases & (2.1%) from all studied groupOur study showed that 100% of group (A) Grade I & II were medical &100% of
group (C) Grade IV & V were surgical while in group (B) Grade III there were about 58% medical & 42% surgical.
Key words:Urinary Tract Infection,Vesicoureteric Reflux,pyelonephritis.