The initial renal ultrasound examination in children with urinary tract infection: the prevalence of dilated uropathy has decreased

Abstract

Background: Pelvocalyceal dilatation (PCD) is often detected by sonography during the prenatal period. Prenatal detection of PCD should affect the prevalence of PCD in children with urinary tract infection (UTI).

Purpose: To determine the prevalence of abnormal sonographic findings in a population of children undergoing first imaging evaluations after UTI and to determine if the prevalence has changed from an earlier study at the same institution.

Materials and methods: The findings on consecutive first renal and bladder sonographic examinations in 844 children (745 girls, 99 boys) with UTI were retrospectively reviewed. Cystograms were performed in 743/844 (494 nuclear, 249 fluoroscopic). Only children with known congenital malformations or other significant disease were excluded.

Results: Sonography was abnormal in 141/844 (16.7%). PCD was noted in 27/844 (3.2%), with mild PCD in 18/844 (2.1%) and moderate or severe PCD in 9/844 (1.1%). Hydroureter without PCD was noted in 6/844 (0.7%). Parenchymal abnormalities were present in 42/844 (5.0%) and bladder wall thickening in 43/844 (5.1%). Vesicoureteral reflux was present in 186/743 (25.0%). When compared to historical controls, PCD and hydroureter were significantly less prevalent than 1 decade earlier (P < 0.0001).

Conclusion: The prevalence of PCD in children under first imaging evaluation for UTI declined significantly during the last decade. These data may be useful in the design of imaging strategies for children with UTI.