CLINICAL DIAGNOSIS OF VESICOURETERAL REFLUX: A MULTICENTRE STUDY

Key words: Micturating cystourethrography, Renal ultrasonography, Urinary tract infection, Vesico- ureteral reflux

227 children with symptomatic urinary tract infection (UTI), aged from 15 days to 4 years, entered a prospective follow-up study, aimed at identifying some simple criteria which might characterize children at risk of having a vesico-ureteral reflux (VUR). Age, sex, acute phase reactants and ultrasound findings during the UTI acute phase, presence or absence of fever and history of symptoms preceding fever onset were evaluated in children with and without VUR. VUR was more frequent in three conditions: in females (56%) vs males (20%) after the first 3 months of life; in children without other symptoms before fever onset (73%) vs those with at least one symptom (17%); in children with persistent ultrasonographic pyelectasia (48%) vs those with normal echography during UTI or with transient pyelectasia (13%). The data provide some simple clinical criteria to identify children with UTI at risk of having a VUR, and might therefore be useful to reduce the indications for a micturating cystourethrography in children with UTI in the first 4 years of age.