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S4-18
(P)
PIC CYSTOGRAPHY AND REDO-PIC CYSTOGRAPHY IN CHILDREN WITH
RECURRENT FEBRILE URINARY TRACT INFECTIONS AND NEGATIVE VOIDING
CYSTOURETHROGRAPHY
David Terence THOMAS
1
, Kivilcim KARADENIZ CERIT
1
, Raziye ERGUN
2
, Nurdan YILDIZ
3
, Harika ALPAY
3
, Sabahat
INANIR
4
, Tolga E. DAGLI
2
and Halil TUGTEPE
2
1) Marmara University School of Medicine, Pediatric Surgery, Istanbul, TURKEY - 2) Marmara University School of
Medicine, Pediatric Surgery, Division of Pediatric Urology, Istanbul, TURKEY - 3) Marmara University School of Medicine,
Pediatric Nephrology, Istanbul, TURKEY - 4) Marmara University School of Medicine, Nuclear Medicine, Istanbul, TURKEY
PURPOSE
In this study we evaluated the value of PIC cystography in patients with febrile recurrent urinary tract infection where
VCUG was negative and evaluated the effectiveness of redo-PIC.
MATERIAL AND METHODS
Recruitment for this prospective study was performed between June 2011 - April 2014 and follow-up until December
2014. The study included patients with recurrent f-UTI with no reflux on VCUG. A PIC cystography was performed in all
patients. When reflux was found, subureteric injection was performed. Urinary cultures were used for follow-up. Patients
that continued having f-UTI, received redo-PIC cystography.
RESULTS
PIC cystography was performed on 35 patients. The average age of patients was 8.0±3.8 years. VUR was detected in 34
patients. Average follow-up time after PIC cystography was 30.0 months. Twenty-eight patients (82.3%) were free of f-
UTI after PIC cystography and concurrent subureteric injection. Six patients continued to have recurrent f-UTI. Four of
these patients underwent redo-PIC cystography and PIC-VUR was demonstrated in all patients. After an average
followup of 21.9 months, no f-UTI was seen in these patients. The success rate of 82.4% after 1st PIC cystography and
subureteric injection increased to 94.2% after redo-PIC cystography in 4 patients.
CONCLUSIONS
Patients with recurrent f-UTIs without VUR on VCUG are an important challenge. PIC cystography is an important tool in
demonstrating occult VUR in these patients. We advise that PIC cystography is performed in all patients with recurrent f-
UTI with negative VCUG and redo-PIC cystography in patients who continue to have f-UTI after 1st PIC cystography and
subureteric injection.