Occurrence of vesicoureteral reflux in children.
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.
Venhola
M
M
Department of Paediatrics, University Hospital, Oulu, Finland. mika.venhola@ppshp.fi
Hannula
A
A
Huttunen
N-P
NP
Renko
M
M
Pokka
T
T
Uhari
M
M
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*