الفهرس | Only 14 pages are availabe for public view |
Abstract Vesicoureteral reflux is a common non benign problem among children with urinary tract infection. Our study included 46 patients with proved UTI,they were submitted to complete history taking, physical examination, serum creatinine and blood urea, and radiological investigations likeAbd. U/S, KUB, IVU (in patients with high serum creatinine levels CT or MRU were done), VCUG and DMSA scan in 20 patients hadreflux; in cases of suspected neurogenic bladder urodynamic studies were done. We found that reflux affects females more than males with ratio about 4:1. Higher grades of reflux are commonlyassociated with abnormal renal anatomy and abnormal bladder functions. US is not sufficient to exclude vesicoureteral reflux or renal scarring, while it could be done every 3 to 4 months to monitor. Voiding cystourethrograme is essential in every child with suspected VUR. DMSA scan is the reliable investigation for early detection of renal affection and cortical scarring. A high number of patients had renal scarring and reflux nephropathy at presentation thus, early detection and treatment of reflux is recommended. Antibiotics should be prescribed in all children with urinary tract infection until the underlying cause is identified. Conservative treatment is sufficient in most cases with low grades of reflux and young ages as spontaneous resolution is a high possibility.Consider surgical treatment is in high grades of reflux especially with abnormal kidneys and renal scarring to prevent further renal damage and end stage renal disease. |