Abstract
PURPOSE: Breakthrough urinary tract infections (UTI) were considered an indication for surgical intervention in children with vesicoureteral reflux (VUR) with the goal of preventing renal scarring. We assessed the influence of reflux grade on the incidence of breakthrough UTI in patients with primary VUR.
MATERIALS AND METHODS: We retrospectively analyzed 425 (male/female: 281 144, bilateral/unilateral: 229/196) patients with primary VUR. There were 33, 64, 99, 131, and 98 patients with VUR of grade I, II, III, IV, and V respectively.
RESULTS: Of 425 cases 90 (21.2%) had breakthrough UTI, and 50, 25, 8, 6, and 1 cases had once, twice, thrice, 4times, and 5times of breakthrough UTI respectively. None (0%), 3 (4.7%), 15 (15.2%), 44 (33.6%), and 28 (28.6%) cases had breakthrough UTI in each grade I, II, III, IV, and V group, respectively. Patients with higher grade VUR have more times of breakthrough UTI significantly (p<0.01). Of patients with primary high-grade VUR, 31.4% had experienced breakthrough UTI, while of patients with primary low- and middle grade VUR, 9.2% had experienced breakthrough UTI.
CONCLUSIONS: Patients with primary high-grade VUR had higher incidence of breakthrough UTI than that with primary low- or middle grade VUR. Our findings may endorse the uselessness of antibiotic prophylaxis as well as continued nonoperative management for the low- or middle-grade VUR.
