The risk factors for recurrence of febrile urinary tract infection and renal scarring in children with functional urinary incontinence

Cetın, Nuran; Tufan, Aslı; Tokar, Baran

doi:10.1111/luts.12349

Cited by 3 publications

(1 citation statement)

References 46 publications

(81 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 In a study by Milosevic et al 21 , ultrasound BWT measurement predicted the occurrence of recurrent UTI in patients with non-NB. Moreover, Cetin et al 22 reported that BWT might be a risk factor for renal scarring. In this study, increased BWT was associated with recurrent UTI.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Recurrent Urinary Tract Infection in Children With Neurogenic Bladder Following Clean Intermittent Catheterization

Jiang

Deng

Zhou

et al. 2022

Urology

View full text Add to dashboard Cite

To investigate the risk factors for recurrent urinary tract infection (UTI) in children with a neurogenic bladder (NB) managed by clean intermittent catheterization. MATERIALS AND METHODSOver a 5-year period, we retrospectively assessed the risk factors for recurrent UTIs in children (age 9-151 months) who had clean intermittent catheterization. All patients were followed up for more than 12 months and had at least two clinic visits during the study period. Demographic, clinical, and urodynamic parameters were assessed. All data were compared between the recurrent UTI (>1.0 UTI/study-year) and episodic UTI (≤1.0 UTI/study-year) groups. RESULTSOf 327 patients, 79 (24.2%) had recurrent UTIs and 248 (75.8%) had episodic UTIs. Univariate and multivariate analyses showed that older age, lumbar level lesions, long duration of NB, presence of vesicoureteral reflux, increased bladder wall thickness, and low bladder compliance were the significant factors for recurrent UTIs. Bladder trabeculation was associated with recurrent UTIs on univariate analysis, but not on multivariate analysis. During the follow-up period, chronic renal insufficiency was diagnosed in 31 (39.2%) and 29 patients (11.7%) in the recurrent and episodic UTI groups (P <.05), respectively. CONCLUSION These results suggest that older age, high level of spinal cord lesions, long duration of NB, vesicoureteral reflux, increased bladder wall thickness, and low bladder compliance may be directly associated with recurrent UTIs in children with NB. Children with NB might have higher susceptibility to chronic renal insufficiency after recurrent UTIs. UROLOGY 00: 1−6, 2022. © 2022 Elsevier Inc.N eurogenic bladder (NB) is defined as a dysfunctional bladder because of a spinal cord lesion at any level. 1 This condition contributes to various pathophysiological mechanisms of NB in children, including urine retention, incontinence, urinary tract infection (UTI), and vesicoureteral reflux (VUR), and ultimately leads to renal scarring and renal failure. 1 Conservative treatment should be performed immediately after the confirmed diagnosis of NB. 2 Clean intermittent catheterization (CIC) or intermittent self-catheterization is commonly recommended for patients with NB having bladder emptying problems. 3 The introduction of CIC has significantly decreased the cases of renal deterioration by reducing the bladder pressure and preventing upper urinary tract damage. 4 However, CIC increases the risk of bacteriuria in patients with NB by introducing urethral microorganisms into the urinary bladder during the repeated catheterizations. 5 Interestingly, some patients with NB managed by CIC have recurrent symptomatic UTIs, but others rarely or never experience them. 5 Hence, few factors may increase the risk of recurrent symptomatic UTIs. Moreover, recurrent UTI, especially pyelonephritis, results in renal scarring and contributes to kidney deterioration. 3 Therefore, identifying the possible risk factors for recurrent symptomatic UTI in children is necessary. Although the ris...

show abstract

Section: Discussionmentioning

confidence: 99%