Background- Recent guidelines on urinary tract infection
(UTI) agree on reducing the number of invasive procedures.
None of these has been validated by a long-term study. We
describe our 11-years experience in the application of a
diagnostic protocol that uses a reduced number of invasive
procedures.
Methods- We reviewed retrospectively the records of 406
children aged between 1 and 36 months at their first UTI.
All patients underwent renal ultrasound (RUS). Children
with abnormal RUS and those with UTI recurrences underwent
voiding cystourethrography (VCUG) and dimercaptosuccinic
acid (DMSA) renal scans.
Results- RUS after the first UTI was pathological in 7.4%
children; 4.4 % had a second UTI.We performed 48 VCUG:
14 patients (29%) had vesicoureteral reflux (VUR), 12 of
which showed an abnormal RUS while 2 had recurrent UTI.
After DMSA renal scan renal damage appeared in only 6 of
them (12.5%); all these children showed grade IV VUR.
Conclusions- The application of our guidelines leads to a
decrease in invasive examinations without missing any useful
diagnoses or compromising the child’s health.
