Utility of follow-up renal sonography in children with vesicoureteral reflux and normal initial sonogram.
OBJECTIVE
The purpose of this study was to determine the value of follow-up renal sonography in children who presented with urinary tract infection and were found to have a voiding cystogram diagnosis of vesicoureteral reflux while having a normal initial renal sonogram.


METHODS
We retrospectively reviewed the medical records of 64 consecutive children who presented for follow-up renal sonography with a voiding cystogram diagnosis of vesicoureteral reflux and a normal initial sonogram conducted as part of the routine evaluation after urinary tract infection. Data recorded included gender, age, initial grade of reflux, time to follow-up sonogram, and abnormalities on follow-up sonogram. Children with conditions that may predispose to vesicoureteral reflux were excluded.


RESULTS
Children who were studied (7 boys, 57 girls) ranged in age from 1 month to 10 years, 10 months (mean: 35.6 months; median: 24 months). Ninety-four (73.4%) of 128 renal units demonstrated vesicoureteral reflux on voiding cystogram; 89 (94.7%) of 94 of them were grade 1 to 3. The mean time to follow-up was 22 months (range: 4 months to 5 years, 2 months; median: 18 months). All 128 (95% confidence interval: 0%-2.8%) renal units were normal on follow-up sonography.


CONCLUSIONS
Routine performance of repeat sonography seems unnecessary among children, particularly girls, with low- to medium-grade vesicoureteral reflux, who have had a previous normal sonogram and no conditions that predispose to vesicoureteral reflux.
Department of Radiology, Children's Mercy Hospital and University of Missouri, Kansas City, Missouri 64108, USA. lhlowe@cmh.edu
Lisa H
LH
Lowe
Manish N
MN
Patel
John M
JM
Gatti
Uri S
US
Alon
D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000000981:diagnostic imaging