title: Voiding urosonography as first step in the diagnosis of vesicoureteral reflux in children: a clinical experience.
abstract: BACKGROUND
  Contrast-enhanced voiding urosonography (VUS) is becoming more widely used for the diagnosis of vesicoureteric reflux (VUR), but until now its use has only been accepted for first diagnosis in females and in the follow-up of children, including boys, who have already undergone voiding cystourethrography (VCUG).
  
  
  OBJECTIVE
  To describe our 6-year experience with VUS used as a first step in the diagnosis of VUR.
  
  
  METHODS
  A total of 610 children (334 boys, 276 girls; mean age 22 months), underwent VUS as the first step in the diagnosis of VUR. In selected children, VCUG was also performed.
  
  
  RESULTS
  VUR was detected in 199 of 610 VUS examinations, and 265 refluxing kidney-ureter units were found. Children with VUR underwent antibiotic prophylaxis or surgery. Children without VUR underwent clinical follow-up. Just 60 children underwent VCUG. The criteria for VCUG were: high-grade VUR after consultation with a urologist, onset of urinary tract infection while receiving prophylaxis, nondiagnostic VUS, and other malformations with or without clinical signs.
  
  
  CONCLUSIONS
  Our experience suggests that we can use VUS as the first step in the diagnosis of VUR in children, boys and girls, with a significant reduction in radiation exposure.
authors.affiliation: Pediatric Nephrology and Dialysis Unit, Pediatric Hospital Giovanni XXIII, Via Amendola 207, 70126 Bari, Italy. mariogiordanobari@fastwebnet.it
authors.forename: Mario
authors.initials: M
authors.lastname: Giordano
authors.forename: Rocco
authors.initials: R
authors.lastname: Marzolla
authors.forename: Flora
authors.initials: F
authors.lastname: Puteo
authors.forename: Lucio
authors.initials: L
authors.lastname: Scianaro
authors.forename: Domenica Angela
authors.initials: DA
authors.lastname: Caringella
authors.forename: Tommaso
authors.initials: T
authors.lastname: Depalo
mesh_terms: D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010743:Phospholipids; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride