The Relationship Between Vesicoureteral Reflux and Recurrent Urinary Tract Infection in Children in Kurdistan Region, Iraq

Background: Recurrent urinary tract Infection (UTI) is a common problem in pediatric age group. Vesicoureteral reflux (VUR) is a common cause for recurrent UTI. Objectives: This study was conducted to determine the prevalence of VUR in children who presented with recurrent UTIs and to assess the effect of endoscopic treatment in patients with grade III-V VUR. Methods: This was a prospective study recruiting 1232 patients who presented with recurrent UTI during April 2008 and January 2012. We used voiding cystourethrogram to diagnose VUR, and treated grades III-V VUR by bulking agent. One to 2 sessions were performed and the participants were followed-up postoperatively at first, second, third, and 12th months postoperatively. Results: VUR was found in 437 (35.5%) of the patients. Amongst those, 197 (16%) patients were diagnosed with VUR grade I and II. Additionally, 240 (19.5%) cases were diagnosed with VUR III-V. Two sessions were required to correct the reflux in all patients with grade III. The success rate of correction of grade IV was 79% after the second session. The success rate was 71% in grade V. New contralateral reflux with low grade (I and II) de novo VUR was found in 28/240 (11.7%) cases. After successful correction of VUR, UTI occurred in 12/203 (5.9%) of the patients. Conclusions: VUR was common in children with recurrent UTI with a good prognosis after endoscopic correction. Further study is needed to follow-up the participants who did not respond to treatment.