Objective: The purpose of this study was to determine if the frequency of vesicoureteric reflux on voiding cystourethrography in children with a history of urinary tract infection varies according to the specialty of the physician requesting the examination.
Materials and methods: The study included 309 children (192 girls, 117 boys) with a history of urinary tract infection who had their first voiding cystourethrogram. The median age at first voiding cystourethrogram in boys was 12 months; in girls, it was 48 months. The reports of these examinations were retrospectively reviewed, and the presence of vesicoureteric reflux was recorded. The age and sex distribution of children referred for voiding cystourethrography by pediatric urologists and nephrologists (subspecialists) was compared with the age and sex distribution of children referred by pediatricians, family practitioners, and adult urologists (other clinicians). The rate of detection of vesicoureteric reflux was calculated according to age and sex. Ages studied were younger than 1 year, younger than 2 years, 2-4 years, and 5 years or older. The frequency of vesicoureteric reflux in children referred by subspecialists was compared with the frequency in children referred by other clinicians, allowing for the age and sex of the children.
Results: The sex distribution of children referred for voiding cystourethrography was similar for subspecialists and other clinicians. More children younger than 2 years old were referred by other clinicians than by subspecialists. Vesicoureteric reflux was found in 30% of boys and 29% of girls. The frequency of reflux in boys did not change with age. The frequency of reflux in girls 5 years or older (15%) was less than in younger girls. We found no significant difference between the rates of reflux in boys and girls within the age groups examined. The overall rate of detection of reflux in patients referred by subspecialists (30%) was almost the same as that in patients referred by other clinicians (29%). We also found no difference in the frequency of reflux in children referred by subspecialists compared with children referred by other clinicians after allowing for the age and sex of the children.
Conclusion: In children with a history of urinary tract infection, the rate of detection of vesicoureteric reflux on voiding cystourethrography is independent of the specialty of the physician requesting the examination.