Background and aims Delay in diagnosis or insufficient treatment of recurrent urinary tract infections (UTI) may lead to hypertension, growth retardation, reflux nephropathy or chronic kidney failure. The aim of our study is to establish the incidence of urinary system anomaly at recurrent UTI and to compare the findings of urinary tract ultrasonography (USG), voiding cystourethrogram (VCUG) and Technetium-99 dimercaptosucsinic acid scintigraphy (DMSA).
Methods Our study included 92 children at age of 0 to 14 years old. Inclusion criteria’s were: been diagnosed as UTI at least two times, had at least two positive urine culture and completed USG, VCUG ve Tc-99 m DMSA scintigraphy.
Results The mean age of subjects was 2.84 ± 3.14 years old (female/male ratio: 1.8/1). The mean age of VUR diagnosis was 3.31 ± 2 years with a female/male ratio of 2.6/1. The renal scar has found at 27.2% in subjects with a diagnosis of VUR (23.9%). Renal scar was significantly higher at subjects who had grade 3, 4 and 5 VUR, 9.7% of subjects who specified normal by USG had a diagnosis of VUR by VCUG (sensitivity: 59%, specifity: 87%), 2.7% of subjects with normal VCUG were diagnosed as abnormal by DMSA (sensitivity: 72.7%, specifity: 97.1%, pozitive predictive value was 88.8% and negative predictive value was 91.89%.
Conclusions VCUG and DMSA scintigraphy are very sensitive diagnostic tests at diagnosis of recurrent urinary tract infections. Using of these tests in children with recurrent urinary tract infections will prevent development of renal damage.
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