Background: Recurrent urinary tract infections (UTIs) may be associated with long-term renal damage. Children diagnosed with Vesicoureteral reflux (VUR), whether after a primary UTI or due to antenatal hydronephrosis (ANH), are treated with prophylactic antibiotics in order to prevent UTIs. The necessity of such treatment has been questioned.
Objective: To determine whether children with VUR detected as a part of ANH assessment, are at risk for UTIs, compared to children after a primary UTI.
Methods: A cohort study based on medical records of children who underwent a voiding cystourethrography (VCUG) in “Assaf Harofeh” Medical center during a 7 year period. In cases when follow-up time was less than 6 months, information was gathered
by telephone, questioning the parents and primary physician.
Results: Our study group included 285 children, of whom 176 had a primary UTI and 109 had ANH. Follow-up time was at least 6 months and over 12 months in 80% of patients. 28 UTIs were recorded. Among children following a primary UTI, the incidence of a recurrent UTI was 12.5% compared to 5.5% among children with ANH (P=0.049). Girls had a much greater risk for recurrent UTIs (HR up to 3.3) (P=0.044). Risk for recurrent UTIs did not differ between children with or without VUR.
Conclusions: As girls are at higher risk for recurrent infections, regardless of the presence of VUR, VUR degree, ANH or a previous UTI, we believe management guidelines for UTI should address females and males separately.
