87 / 492
S4-11
(P)
DOES APPLICATION OF THE NEW ESPU/EAU GUIDELINES ON URINARY TRACT
INFECTIONS IN CHILDREN INFLUENCE THE VUR DETECTION RATE?
Bernhard HAID, Judith ROESCH and Josef OSWALD
Hospital of the Sisters of Charity, Department of Pediatric Urology, Linz, AUSTRIA
INTRODUCTION
Recently, the ESPU/EAU recommendations for further evaluation of the upper urinary tract after febrile urinary tract
infections (UTIs) in children have changed. Instead of performing an upper tract evaluation by voiding
cystourethrography (VCUGs) in every child after the first febrile UTI, a more differentiated approach, based on age,
gender and ultrasound findings is recommended.
We aimed to evaluate the number of performed VCUGs and the VUR detection rate comparing the former to the new
version of the guidelines.
PATIENTS AND METHODS
We retrospectively evaluated 541 consecutive patients (male/female 28/72%, median age 1,83 years) who underwent
as well sonography at the time of UTI as well as primary VCUG after febrile UTIs. Potty-trained children with severe
bladder emptying disorders were excluded. Subsequently we analyzed these patients in light of the new guidelines.
RESULTS
Of 220 patients (40,7%) with pathological ultrasound findings 85 (39%) had VUR. Of 321 patients (59,3%) with normal
ultrasound 291 patients were eligible for VCUG according to the new guidelines, 80 thereof (26,9%) had VUR. 24
VCUGs (4,4%) that would have been performed according to the former guidelines would have been omitted, 6 VURs,
thereof 3 ≥°III, would not have been detected.
CONCLUSIONS
The new guidelines maintain a high sensitivity in VUR detection, only 3,5% (6/171) of formerly detected VURs would not
have been detected. None of the 24 boys that would not have undergone a VCUG had a urethral pathology. However,
the reduction in performed VCUGs is low (-24/541 VCUGs, -4,4%).