Does routine ultrasound change management in the follow-up of patients with vesicoureteral reflux?

Authors

  • Jan K. Rudzinski Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
  • Bryce Weber Department of Pediatric Urology, Alberta Children’s Hospital, Calgary, Alberta, Canada
  • Petra Wildgoose The Hospital for Sick Children in Toronto, Ontario, Canada
  • Armando Lorenzo The Hospital for Sick Children, Division of Pediatric Urology, Toronto, Ontario
  • Darius Bagli The Hospital for Sick Children, Division of Pediatric Urology, Toronto, Ontario
  • Elizabeth Harvey The Hospital for Sick Children, Division of Nephrology, Toronto, Ontario
  • Joao Luiz Pippi Salle The Hospital for Sick Children, Division of Pediatric Urology, Toronto, Ontario

DOI:

https://doi.org/10.5489/cuaj.202

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.

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Published

2013-07-02

How to Cite

Rudzinski, J. K., Weber, B., Wildgoose, P., Lorenzo, A., Bagli, D., Harvey, E., & Pippi Salle, J. L. (2013). Does routine ultrasound change management in the follow-up of patients with vesicoureteral reflux?. Canadian Urological Association Journal, 7(7-8), E467–9. https://doi.org/10.5489/cuaj.202

Issue

Vol. 7 No. 7-8 (2013): CUAJ July

Section

Original Research

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