Research Information System
Acta Radiologica, vol.66, no.10, pp.1077-1084, 2025 (SCI-Expanded)
Background: Voiding cystourethrography (VCUG) remains the best method to diagnose and to determine vesicoureteral reflux (VUR) grade. Purpose: To determine necessity and indications of VCUG and to investigate high-grade VUR predictors. Material and Methods: We retrospectively reviewed data. The patients were sorted into three age groups: 0–12 months; 13–24 months; and above 24 months. Student t-test, Mann–Whitney U test, ANOVA, and Kruskal Wallis test were used to compare the means between groups. Pearson’s correlation test was used for correlation analysis. Risk factors were determined by multivariate regression analysis. Results: The most common indication for VCUG was recurrent urinary tract infections (UTIs). VCUG revealed VUR in 96 (18.4%) patients, posterior urethral valve (PUV) in 13 (2.5%) patients, and bladder anomalies in 14 (2.6%) patients. Neither sex nor age was statistically significantly associated with presence or grades of VUR. Multivariate analysis showed that a history of recurrent UTI (P = 0.008), a presence of high-grade hydronephrosis (HN) on renal-bladder ultrasound (RBUS) (P = 0.001), and a presence of scarring on dimercaptosuccinic acid renal cortical scintigraphy (DMSA) (P < 0.001) were strongly associated with high-grade VUR. In addition, female sex, renal dysfunction, high-grade VUR, history of recurrent UTIs, and older age at diagnosis were identified as risk factors for renal scarring. Conclusion: We highlight that the most common indication for VCUG is recurrent UTIs, which is associated with higher renal damage and high-grade VUR. If a VCUG should be considered for children with recurrent UTIs, high-grade HN and renal scaring, which are the predictors of high-grade VUR.