title: Occurrence of vesicoureteral reflux in children.
abstract: OBJECTIVE
  The reported low occurrence of vesicoureteral reflux in the general population seems implausible. We wanted to test the hypothesis that reflux is more common and more independent of urinary-tract infection than has previously been thought.
  
  
  METHODS
  We tested our hypothesis by analysing the characteristics of 406 consecutive children aged <5years who had been referred for consultation because of urinary-tract infection. Using data on their urine samples, we evaluated the reliability of the urinary-tract infection diagnosis and analysed the frequencies of vesicoureteral reflux and abnormal ultrasound findings in three reliability groups (A: certain urinary-tract infection, B: possible and C: improbable).
  
  
  RESULTS
  The occurrence of reflux was the same irrespective of the diagnostic reliability of urinary-tract infection (A: 98/276 [36%] versus B: 13/46 [28%] versus C: 9/25 [36%]). Most of the abnormal ultrasound findings (58/71, 80%) were found among patients with a certain diagnosis (Group A).
  
  
  CONCLUSIONS
  We suggest that vesicoureteral reflux is more common in children even without urinary-tract infection than has been thought previously. The guidelines recommending a search for reflux by means of voiding cystourethrography should be reconsidered.
authors.affiliation: Department of Paediatrics, University Hospital, Oulu, Finland. mika.venhola@ppshp.fi
authors.forename: M
authors.initials: M
authors.lastname: Venhola
authors.forename: A
authors.initials: A
authors.lastname: Hannula
authors.forename: N-P
authors.initials: NP
authors.lastname: Huttunen
authors.forename: M
authors.initials: M
authors.lastname: Renko
authors.forename: T
authors.initials: T
authors.lastname: Pokka
authors.forename: M
authors.initials: M
authors.lastname: Uhari
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology*; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology*