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Objective: Increased incidence of lower urinary tract dysfunction (LUTD) has been reported in older children with vesicoureteral reflux (VUR), and its treatment affects patient outcome. The optimal initial imaging method is often difficult for clinicians to select in this patient group. The aim of the study was to investigate the value of videourodinamic studies (VUD) in the detection and management of VUR in children with recurrent urinary tract infections and lower urinary tract symptoms such as urge, urge incontinence, weak stream, and frequency. Material and Methods: The study included 117 children with 234 kidney-ureter units (KUUs). The clinical patient records of DMSA scintigraphy, voiding cystouretrography (VCUG), and VUD were reviewed retrospectively. Results: Vesicoureteral reflux was identified in 108 of 234 KUUs (46%). In 55% of refluxing KUUs, VUR was exhibited by both techniques while 25% of refluxing KUUs were exhibited by only VCUG, and 19% of refluxing KUU by only VUD. Bladder instability was detected in 55 of 74 (74%) patients with VUR, and in 34 of 43 (79%) patients without VUR. There was moderate concordance in the diagnosis of VUR by VUD and VCUG (?=0.55±0.05), but the difference in reflux detection rate between VUD and VCUG was not statistically significant (p=0.47). Conclusion: Our findings indicated that VUD and VCUG techniques exhibit equal reliability in the diagnosis of VUR, and VUD provides additional information concerning LUTD. Copyright © 2013 by Türkiye Klinikleri. |
