Does Routine Ultrasound Change Management in the Follow-up of Patients with Vesicoureteral Reflux?

Overview

Journal Can Urol Assoc J

Specialty Urology

Date 2013 Aug 6

PMID 23914261

Citations 1

Authors

Jan K Rudzinski

Bryce Weber

Petra Wildgoose

Armando Lorenzo

Darius Bagli

Walid Farhat

Elizabeth Harvey

Joao Luiz Pippi Salle

Affiliations

Soon will be listed here.

Abstract

Introduction: Children with vesicoureteral reflux (VUR) usually need a renal ultrasound (RUS). There is little data on the role of follow-up RUS in VUR. We evaluated the impact of follow-up RUS on the change in clinical management in patients with VUR.

Methods: We prospectively analyzed children with a previous diagnosis of VUR seen in the outpatient clinic with a routine follow-up RUS within 4 months. Variables collected included: demographic data, VUR history, dysfunctional voiding symptoms and concurrent ultrasound findings. Change in management was defined as addition of new medication, nurse counselling, surgery or further investigations.

Results: The study included 114 consecutive patients. The mean patient age was 4.5 years old, mean age of VUR diagnosis was 1.7 years, with average follow-up of 2.8 years. A change in management with stable RUS occurred in 14 patients, in which the change included ordering a DMSA in 9, nurse counselling for dysfunctional voiding in 3, and booking surgery in 2 patients. Change on RUS was seen in 4 patients. Multivariable analysis showed that history of urinary tract infection (UTI) since the last follow-up visit was more significant than RUS findings.

Conclusions: The RUS findings in most patients followed for VUR remain stable or with minimal changes. The variable showing a significant effect on change in management in our study was history of UTI since the last follow-up visit rather than RUS findings. The value of follow-up RUS for children with VUR may need to be revisited.

Citing Articles

Evidence-based clinical practice guideline for management of urinary tract infection and primary vesicoureteric reflux.

Hari P, Meena J, Kumar M, Sinha A, Thergaonkar R, Iyengar A Pediatr Nephrol. 2023; 39(5):1639-1668.

PMID: 37897526 DOI: 10.1007/s00467-023-06173-9.

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