All issues > Volume 35(12); 1992

Original Article

J Korean Pediatr Soc. 1992;35(12):1713-1721. Published online December 15, 1992.

Follow up Study of Urinary Tract Infection Associated with Vesicoureteral Reflux

Kyung Hee KH Kim¹, Young Jin YJ Hong¹, Soon Wha SW Kim¹, Don Hee DH Ahn¹

¹Department of Pediatrics, National Medical Center, Seoul, Korea

Abstract

The authors studied 25 cases with urinary tract infection associated with vesicoureteral reflux who were admitted to department of pediatrics, National Medical Center. The patients were managed medically or surgically and followed up. The results were summarized as follows; 1) There were no difference in age and sex distributions of the 25 cases with vesicoureteral reflux. 2) The degree of reflux classified by International Reflux Study Committee were; Grade I in 5 cases, grade II in 7 cases, grade III in 8 cases, grade IV in 4 cases and grade V in one case. As for the site, the reflux was found on both in 11 cases, right side in 4 cases and left side in 10 cases. 3) Twelve cases (48%) suffered from urinary tract infection twice or more. The most common causative agent in urinary infection was E. coli. In order of frequency, the next were Proteus species and Enterococcus, Klebsiella pneumonia, Pseudomonas aeruginosa, Enterobacter species, Serratia marcescence, Staphylococcus aureus and group A B-hemolytic streptococcus. 4) Twenty one cases were underwent ultrasonography and 12 cases (57.1%) of them showed abnormal findings, which were enlarged kidney, dilated pelvis, scarring and reduced size, hydronephrosis, duplication of kidney, renal cyst, hypoplasia, cortical thinning, atrophic kidney, ectopic ureteral orifice and ureterovesical junction stricture. 5) Twelve cases were underwent IVP and 8 cases (66.7%) of them showed abnormal findings which were hydronephrosis, non-functioning kidney, dilated ureter, renal scarring, parenchymal thinning, renal cyst, hypertrophic kidney, hypoplasia, dilated pelvis, cortical thinning and duplicated kidney. 6) The combined congenital anomalies in vesicoureteral reflux were duplicated kidney, ectopic ureteral orifice, bladder diverticulum, imperforated anus with recto-ureteral fistula, double ureter and ureteral stricture. 7) Nineteen cases were treated medically and 11 cases of them were followed up. The period of follow up was 2-26 months (mean 8.1 months). Control VCUG was done in 11 cases and 8 cases (72.7%) of them showed disappearance of reflux. But the rest, 3 cases (27.3%) showed persistent or aggrevated state. Five cases were treated surgically and 4 cases of them were followed up. Control VCUG was done in 4 cases and all of them showed improved state. 8) The complications of vesicoureteral reflux were chronic renal failure in 2 cases, renal scarring in 2 cases, chronic pyelonephritis in one case and atrophy in one case.

Keywords :Vesicoureteral reflux, urinary tract infection