What Should Be the Follow Up Investigations After First Time UTI in Children?
The purposes of investigations are to detect underlying anatomical abnormalities of the urinary tract, to look for VUR, to assess renal functions and degree of scarring of each kidney, and to look for bladder dysfunction. The choice of each test depends on its sensitivity of picking up the abnormalities, its degree of invasiveness and dose of irradiation. The ultrasonogram (USG) is best at detecting anatomical anomalies and kidney sizes. The dimercaptosuccinic acid scan (DMSA) is most sensitive at picking up renal scars and also give differential renal function. The intravenous urogram (IVU) can assess kidney sizes, scarring and differential function but it is seldom used because of the difficulty in getting good images in infants. The micturiting cystourethrogram (MCU) can detect urethral and bladder anatomy, detect VUR and grade its severity. Bladder dysfunction is best shown by a formal urodynamic study. Usually a combination of tests has to be performed to identify all potential ab
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