Urinary tract infections (UTIs) occur in 3-5% of girls and 1% of boys. UTIs have been considered an important risk factor for the development of renal insufficiency, hypertension or end-stage renal disease. Hence, there is a need for early diagnosis and management of UTI to prevent renal scarring. The guidelines concerning the prophylactic treatment and the imaging studies have changed during the past year. It was believed that reflux predisposed to renal infection (pyelonephritis) by causing renal injury or scarring and that imaging studies in children with UTI were meant to identify anatomic abnormalities that predispose them to infection and renal scaring. Today, this concept is no longer prevalent and there is no recommendation to perform voiding cystourethrogram (VCUG] after every UTI. AIM: To examine parents' compliance to perform a VCUG test after hospitalization due to UTI and factors affecting their decision. METHODS: We performed a retrospective study that included all children who were hospitalized and diagnosed with UTI at "Dana" Children's Medical Center during the period 1/2004 - 12/2005. Hospital file records were collected, and the relevant data were obtained. We collected data regarding the parents' compliance to perform a VCUG according to a telephone interview. RESULTS: A total of 227 children participated in the study; 179 (78.85%) parents agreed to partake in the interview. Overall, 52% of the children didn't perform the VCUG because of concern about exposure to radiation (55.91%), fear and distress from pain during the test (43.03%), fear of irreversible damage to the urinary tract (40.86%), lack of relevant information (35.48%] and the primary pediatrician's recommendation to postpone the test. The remaining 48% conducted the test because of the hospital doctor's recommendation (94.18%), Primary pediatrician recommendation (94.18%) and because of the desire to terminate prophylactic treatment (63.95%). There is a significant correlation between the doctors' recommendation and the extent and clarity of their explanation to the parents' understanding of the importance of the test, to the parents' satisfaction from the explanation and to the compliance to perform the test. CONCLUSIONS: There is a need to improve the doctors' explanation regarding the performance of VCUG test post UTI. This will improve the patients' compliance to perform their post discharge recommendation.
|Pages (from-to)||227-231, 263, 262|
|State||Published - Apr 2010|