ESPN 50th Annual Meeting

ESPN 2017


 
Role of PIC Cystography for Evaluating VUR in Children With Recurrent Urinary Tract Infection
HULYA NALCACIOGLU 1 DENIZ DEMIRCI 2 GOKHAN SONMEZ 2 SIBEL YEL 1 ISMAIL DURSUN 3 FUNDA BASTUG 1 ZUBEYDE GUNDUZ 3 HAKAN POYRAZOGLU 3 RUHAN DUSUNSEL 3

1- KAYSERI EDUCATION AND RESEARCH HOSPITAL, PEDIATRIC NEPHROLOGY DEPARTMENT, KAYSERI, TURKEY
2- ERCIYES UNIVERSITY FACULTY OF MEDICINE, PEDIATRIC UROLOGY DEPARTMENT, KAYSERI, TURKEY
3- ERCIYES UNIVERSITY FACULTY OF MEDICINE , PEDIATRIC NEPHROLOGY DEPARTMENT, KAYSERI, TURKEY
 
Introduction:

 Voiding cystourethrography (VCUG) is considered as the standard evaluation method for identifying vesicoureteral reflux (VUR) in children with urinary tract infections (UTI). The common pediatric problem is the management of children who have normal VCUG finding with recurrent UTI. PIC cystography is a new modality that has been shown to demonstrate ureteral incompetence in pediatric patients who have normal standard reflux studies. In this study, we evaluated the utility of PIC cystography in detecting VUR in patients with recurrent UTIs that standard VCUG failed to reveal.

Material and methods:

 A retrospective analysis was conducted on 14 patients who were examined with PIC cystography between 2014 and 2016 with a diagnosis of recurrent UTI. All patients had at least one previous negative VCUG. The collected data included patient age, sex, individual ultrasonography (US),  DMSA findings, PIC reports and outcome. 

Results:

 A total of 14 patients were included in the study, of which 3 (21,4%) were male and 11 (78.6%) were female. The mean age of the study group was 9,07±3,92 years. The 8 (57,1%) patient had normal US, 5 patients (35,7%) had bilateral scar detected by DMSA. 12 patients (85,7%) were shown to have VUR on PIC. The relationship between having scar on DMSA and reflux on PIC was evaluated and no statistical difference was found.

Conclusions:

 According to our results,  PIC cystogram appears to be a clinically relevant test in patients who have frequent UTIs with negative VUR on standard imaging modalities. In this sense, we believe that providing prospective randomized study with PIC cystogram is essential to optimize the algorithm for the treatment of children with febrile UTIs to show the hidden VUR.