Voiding urosonography as first step in the diagnosis of vesicoureteral reflux in children: a clinical experience.
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.
Giordano
Mario
M
Pediatric Nephrology and Dialysis Unit, Pediatric Hospital Giovanni XXIII, Via Amendola 207, 70126 Bari, Italy. mariogiordanobari@fastwebnet.it
Marzolla
Rocco
R
Puteo
Flora
F
Scianaro
Lucio
L
Caringella
Domenica Angela
DA
Depalo
Tommaso
T
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*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride