PD2-6: Lower urinary tract dysfunction with vesicoureteral reflux: a more significant factor predicting recurrent febrile uti in infants
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  • 2017-12-22,
  • 上傳者: TUA秘書處,
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下泌尿道功能障礙合併膀胱輸尿管逆流:
一個更有意義預測嬰兒反覆發燒泌尿道感染之指標
方楚文、蘇家震、沈坤宏黃冠華
奇美醫學中心外科部泌尿外科
Lower Urinary Tract Dysfunction With Vesicoureteral Reflux:
A More Significant Factor Predicting Recurrent Febrile UTI in Infants
Chu-Wen Fang, Chia-Cheng Su, Kun-Hung Shen, Steven K. Huan
Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
 
Purpose
Lower urinary tract dysfunction (LUTD) is a recognized risk factor of recurrent UTI. We examined the effects of LUTD alone and LUTD + vesicoureteral reflux (VUR) on the recurrence of UTI in infants.
Materials and Methods:
Infants with febrile UTI, without urogenital or neurological disorders, were prospectively enrolled for study. All underwent VCUG and 4 hours voiding observation with immediate PVR after each voiding. We did the 4 hours voiding observation usually one month after treatment of febrile UTI. Spinning top sign on voiding cystography and/ or interrupted free flow are regarded as LUTD. What is the interrupted flow? It means revoiding withing 5 minutes. Actually, this definition is different from that of staccato flow.
Results:
Totally 38 infants (M:F=26:11) with a mean age of 10.1+/-6.7 months were enrolled for study (Table 1 ). Mean followup period was 42.7+/-12.8 months. LUTD was present and absent in 27 and 11 children respectively. Of the 27 children with LUTD 21 (77.8%) had VUR, including 16 (59.3%) high grade VUR and 11 (40.7%) bilateral VUR. Of the 11 children without LUTD 5 (45.5%) had VUR, including 5 (45.5%) high grade VUR and 1 (9.1%) bilateral VUR. Anti-reflux treatment was performed in 5 (18.5%) children with LUTD and 1 (9.1%) child without LUTD. Recurrent UTI was observed in 13 (48.2%) with LUTD and 4 (36.4%) without UTI (p=0.51). Recurrent febrile UTI was noted in 6 (22.2%) children with LUTD and 0 (0.0%) without LUTD (p=0.088). LUTD with and without VUR were observed in 22 and 16 children respectively. Febrile UTI occurred in 6 (27.3%) and 0 (0.0%) of children with and without LUTD and VUR (p=0.023).
Conclusion: Urinary tract infection (UTI) is one of the most common pediatric infections. It distresses the child, concerns the parents, and may cause permanent kidney damage. LUTD with VUR may represent severe BBD and were associated with statistically higher rate of recurrent febrile UTI in infants.
 
 
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    2017-12-22 16:43:31
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    294
    發表人 :
    TUA秘書處
    部門 :
    台灣泌尿科醫學會
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