Objective This study was designed to determine the predisposing factors in children with symptomatic urinary tract infection (UTI) according to age and gender.
Material and Methods We reviewed prospectively 183 pediatric patients with symptomatic UTI admitted to emergency department or referred to nephrology clinic from November 2002 through July 2005. All patients underwent renal ultrasonography and voiding-cystouretherography or radionuclide cystography. Diuretic renal scan or intravenous pyelography (IVP) was performed in those with urinary system dilatation. Urodynamic studies were done in patients with normal radiologic findings and recurrent infections or urinary-intestinal symptoms.
Findings Of 183 patients, 130 cases (71%) were female and 53 patients (29%) male. Most of the patients (61.9%) were between 2–24 months old (P=0/001). Vesicoureteral reflux (VUR) was the most common predisposing factor in both genders (46.9% in girls and 48.9% in boys). Voiding dysfunction in girls and urinary obstruction in boys were found with a significant difference (P=0/03 for both). In all age groups, except patients≤1 month, the most common predisposing factor was reflux. Reflux, urinary obstruction and nephrolithiasis were found with a significant difference in 2–24 months age group (P=0/001 for all).
Conclusion In our study vesicoureteral reflux (VUR) was as common in boys as in girls, and suggested urolithiasis as a significant UTI predisposing factor. This study showed that voiding dysfunction in girls and urinary obstruction in boys are as significant predisposing factors. We suggest urodynamic studies in patients with normal radiologic findings and recurrent infections or urinary-intestinal symptoms.