The most common underlying anomaly in a child with recurrent urinary tract infections is?
Ans. is 'b' i.e., Vesicoureteric reflux o According to Nelson "The most common abnormality seen in a child with UTI in a voiding cystourethrogram is vescioureteric reflux. It is identified in approximately 40% of patients". Vesicoureteric reflux (VUR) o Retrograde flow of urine from the bladder to the ureter and renal pelvis is referred to as vesicoureteric reflux. o VUR is the source of UTI in 30 to 50% of children. o Recurrence occurs in about 309/0 of boys and 40% of girls. o Recurrences nearly always occur within the first six months after the first UTI. o Vesicoureteric reflex may be primary or secondary. 1) Causes of primary VUR a) Due to developmental ureterotrigonal weakness b) Associated with other ureteral anomalies such as ectopic orifice or ureterocele. 2) Causes of secondary VUR a) Bladder outlet obstruction c) Neuropathic dysfunction e) Inflammation b) Urethral obstruction d) Iatrogenic f) Tubercular infection
Posterior urethral valves
Vesicoureteric reflux
Neurogenic bladder
Renal calculi