OUR EXPERIENCE WITH CONTRAST-ENHANCED VOIDING UROSONOGRAPHY

Vesicoureteral reflux (VUR) is one of the most common anomalies of the urinary system in children. Contrast-enhanced voiding urosonography (ceVUS) is one of the best methods in VUR diagnosis. This study compared characteristics associated with VUR specific images and categorized patients according to a particular VUR grade. The study included 183 children. VUR was detected in 38.9% of patients, mean age 1.7±1.1 years. Grade II VUR was most common (60.3%), followed by grade III (29.4%). Study results showed that VUR occurred irrespective of age, gender, previous ultrasound findings, causative agent, and severity of urinary tract infection (UTI). VUR was more common in children with recurrent UTI. In the group of children with the first UTI not caused by Escherichia coli or with recurrent UTI, boys more commonly suffered from severe VUR (grade IV-V; 66.7%), while girls suffered from moderate VUR (grade II-III; 100%). In this study, the incidence of VUR in prenatally diagnosed hydronephrosis was 28.6%. It is necessary to develop an algorithm for the treatment of children after UTI in Croatia, which should include ceVUS. All children with possible VUR should be referred to a specialized center where it is possible to perform ceVUS.