The prevalence of vesicoureteral reflux and other genitourinary tract abnormalities in children with a history of urinary tract infection undergoing voiding cystourethrography: single-centre study

Introduction:
In this study we aimed to establish the prevalence of vesicoureteral reflux (VUR) and other genitourinary tract abnormalities in children with a history of urinary tract infection (UTI), who underwent voiding cystourethrography (VCUG), in light of the current recommendations of the Polish Society of Paediatric Nephrology (PTNFD).

Material and methods:
Retrospective chart analysis included 366 children aged 0.25-16.17 years, median 1.96 years, interquartile range 3.84 years, with a history of UTI, who underwent VCUG according to PTNFD guidelines in the period from 2019 to 2022 in the Division of Paediatric Nephrology, Department of Paediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. We analysed the outcomes of VCUG among participants reflecting PTNFD indications for VCUG: (1) recurrent UTI, (2) a history of febrile UTI with a septic course, and (3) UTI with ultrasound renal and bladder abnormalities.

Results:
VUR was detected in 118 patients (32.2%). Among the remaining participants, 243 children (66.4%) presented with normal VCUG. In 5 children (1.4%) VCUG revealed urinary bladder diverticulum or posterior urethral valve. In group 1, VUR was found in 90/270 participants (33.3%), in group 2, in 23/70 participants (32.9%), and in group 3, in 5/26 participants (19.2%). There were no significant differences in the occurrence of VUR between study groups.

Conclusions:
The prevalence of VUR in children with a history of UTI who underwent VCUG in light of the current recommendations of PTNFD, which comprise children with recurrent UTI, after septic UTI and after UTI with ultrasound renal and bladder abnormalities, in our study achieved 32.2%. The fact that no aberrations in VCUG were found in nearly two-thirds of children undergoing this procedure may add some relevant arguments for further discussion on the optimisation of the indications for VCUG in children.