ABSTRACT
Background: Urinary tract infection (UTI) is the second most prevalent pediatric infection, and if it is not recognized and treated properly, it can cause severe irreversible complications such as renal failure and hypertension. In this research, some of the risk factors of UTIs were compared in children with urinary tract infections.Methods: This is a cross-sectional study, with the urinary tract infection as the dependent variable and gender, circumcision status, history of urinary catheterization, family history, history of renal stone, hypercalciuria, constipation history, reflux, neurogenic bladder, phimosis, posterior urethral valves (PUV), ureteropelvic junction obstruction (UPJO), and ureterovesical junction obstruction (UVJO) as the independent variables. A total of 405 children were studied in this research. The data was collected using questionnaires, checklists, and examinations. Data analysis was also carried out using descriptive and analytical statistics method in SPSS.Results: This research revealed the prevalence of urinary tract infection among children with several risk factors, and the common factors were positive family history, history of urinary catheterization, constipation, and other non-anatomical disorders (history of renal stone and hypercalciuria. The most common risk factors regardless of gender and age were non-anatomic disorders that were observed in 147 cases (43.7%) (p-value<0.001). Among the non-anatomical factors, constipation was the most common factor observed in 66 cases (16.3%). A higher rate of urinary infection was observed in the uncircumcised male patients than the circumcised patients, and there was a significant relationship between circumcision and UTI.Conclusions: In this study, urinary tract infection staged a significant relationship with gender, circumcision status, urinary catheterization history, family history, renal stone history, hypercalciuria, history of constipation, reflux, neurogenic bladder, phimosis, PUV, UPJO, and UVJO.
ABSTRACT
Objective To investigate the experience of diagnosis and management of coexisting ureteropelvic junction obstruction (UPJO) and nonreflux megaureter (NRM).Methods The retrospective study of UPJO with NRM was based on 10 years information retrieved from January 2005 to December 2015.The data of 13 patients (8 males and 5 females) were available and recorded.Mean age at surgery was 3.7 years old (range 1.8 to 14 years).The diagnosis and mangement were summarized.Coexisting ureterovesical junction obstruction (UVJO) and vesicoureteral reflux,iatrogenic stricture and vesicoureteral reflux were excluded.Intravenous pyelography,voiding cystourethrography,ultrasound and CT reconstruction were performed before operation.Only six patients had an accurate diagnosis as UPJO with UVJO before surgery.Pyeloplasty was the initial surgical management choice for 10 patients,and ureteroneocystostomy in 3 patients.Results UVJO were diagnosed with pyelography techniques in 3 patients after pyeloplasty,while 4 were diagnosed as nonreflux and nonobstruction megaureter.Of the 10 patients who underwent initial pyeloplasty,additional ureteroneocystostomy was required in 3 and the prognosis was good.Additional pyeloplasty was required in 2 of the 3 patients who initially underwent ureteroneoeystostomy.Mean follow-up time from last operation was 23.3 months (6-53 months),the overall prognosis was good.Conclusions It is often difficult to correctly diagnose coexisting UPJO and NRM.In patients with UPJO,it is highly recommended nephrostomy radiography after pyeloplasty to evaluate the distal ureterovesical junction.Initial pyeloplasty is always recommended as first-line therapy.Additional ureteroneocystostomy was required when hydroureteropelvic was aggravated.