The Urologic Abnormalities of Urinary Tract Infection in Children and their Detection

Kim, Keon Seok; Chung, Ky Hyun; Kim, Kwang Myung; Kim, In Won; Yeon, Krung Mo; Choi, Hwang

Abstract

We have reviewed 251 children with urinary tract infection who were seen in our hospital during the last 5 years. Underlying abnormalities of the urinary tract were found in 154 patients(61 %). This figure is high because referred patients from other physicians for further treatment are included here. Of these 154 patients, surgical treatments were required in 85. The most frequent finding was vesicoureteral reflux(110 pts). Obstructive lesions were found in 44 pts ; UPJ obstruction in 9, megaureter in 6, obstruction associated with duplication in 6, urethral valve in 5, neurogenic bladder in 11, and others in 7. Abnormal findings without clinical significance were found in additional 17 pts. To evaluate the role of ultrasonography(US), we have compared findings of intravenous pyelography(IVP) and US. Of 58 pts who had both studies, 52 showed identical findings. US failed in detection of small renal scar and duplication of collecting system. US in combination with voiding cystourethrography(VCU) identified abnormal findings in most cases. It is our impression that US can replace IVP as a screening procedure which should be performed with VCU in every child with proven UTI. And as IVP is superior in imaging anatomical details than US, we recommend IVP before any surgical attempt.