Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral reflux

To evaluate the value of Positional Installation of Contrast (PIC) and Redo-PIC cystography in patients with febrile recurrent urinary tract infection (f-UTI) where voiding cystourethrogram (VCUG) was negative. Patients with recurrent f-UTI with no reflux on VCUG referred to the outpatient clinic o...

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Main Authors: Kıvılcım Karadeniz-Cerit, David Terence Thomas, Raziye Ergun, Nurdan Yıldız, Harika Alpay, Sabahat İnanir, E Tolga Dağlı, Halil Tuğtepe
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2018-04-01
Series:The Turkish Journal of Pediatrics
Subjects:
Online Access:https://turkjpediatr.org/article/view/836
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author Kıvılcım Karadeniz-Cerit
David Terence Thomas
Raziye Ergun
Nurdan Yıldız
Harika Alpay
Sabahat İnanir
E Tolga Dağlı
Halil Tuğtepe
author_facet Kıvılcım Karadeniz-Cerit
David Terence Thomas
Raziye Ergun
Nurdan Yıldız
Harika Alpay
Sabahat İnanir
E Tolga Dağlı
Halil Tuğtepe
author_sort Kıvılcım Karadeniz-Cerit
collection DOAJ
description To evaluate the value of Positional Installation of Contrast (PIC) and Redo-PIC cystography in patients with febrile recurrent urinary tract infection (f-UTI) where voiding cystourethrogram (VCUG) was negative. Patients with recurrent f-UTI with no reflux on VCUG referred to the outpatient clinic of Pediatric Urology, between June 2011 and June 2016 were included in the study. A PIC cystography was performed in all patients. When reflux was found, subureteric injection was performed. Urinary cultures were used for follow-up. Patients that continued having f-UTI, received redo-PIC cystography. PIC cystography was performed on 42 patients. The average age of patients was 8.0±3.6 years. Vesicoureteral reflux (VUR) was detected in 41 patients. Average follow-up time after PIC cystography was 44.6 months. Thirty-three patients (80.5%) were free of f-UTI after PIC cystography and concurrent subureteric injection. Eight patients continued to have recurrent f-UTI. Six of these patients underwent redo-PIC cystography and PIC-VUR was demonstrated in all patients. After an average follow up of 30.9 months, no f-UTI was seen in these patients. The success rate of 80.5% (33/41) after 1st PIC cystography and subureteric injection increased to 95.1% (39/41) after redo-PIC cystography in six patients. Patients with recurrent f-UTIs without VUR on VCUG are an important challenge. PIC cystography is an important tool in demonstrating occult VUR in these patients. We advise that PIC cystography is performed in all patients with recurrent f-UTI with negative VCUG and redo-PIC cystography in patients who continue to have f-UTI after 1st PIC cystography and subureteric injection.
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publisher Hacettepe University Institute of Child Health
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spelling doaj-art-d8b745449a64408cb0b41cece8a568af2025-08-20T02:01:55ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212018-04-0160210.24953/turkjped.2018.02.010Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral refluxKıvılcım Karadeniz-Cerit0David Terence Thomas1Raziye Ergun2Nurdan Yıldız3Harika Alpay4Sabahat İnanir5E Tolga Dağlı6Halil Tuğtepe7Division of Pediatric Surgery, Department of Pediatrics, Marmara University School of Medicine, İstanbul, Turkey.Department of Pediatric Surgery, Maltepe University Faculty of Medicine İstanbul, Turkey.Division of Pediatric Urology, Department of Pediatrics, Marmara University School of Medicine, İstanbul, Turkey.Division of Pediatric Nephrology, Department of Pediatrics, Marmara University School of Medicine, İstanbul, Turkey.Division of Pediatric Nephrology, Department of Pediatrics, Marmara University School of Medicine, İstanbul, Turkey.Department of Nuclear Medicine, Marmara University School of Medicine, İstanbul, Turkey.Division of Pediatric Urology, Department of Pediatrics, Marmara University School of Medicine, İstanbul, Turkey.Division of Pediatric Surgery, Department of Pediatrics, Marmara University School of Medicine, İstanbul, Turkey. To evaluate the value of Positional Installation of Contrast (PIC) and Redo-PIC cystography in patients with febrile recurrent urinary tract infection (f-UTI) where voiding cystourethrogram (VCUG) was negative. Patients with recurrent f-UTI with no reflux on VCUG referred to the outpatient clinic of Pediatric Urology, between June 2011 and June 2016 were included in the study. A PIC cystography was performed in all patients. When reflux was found, subureteric injection was performed. Urinary cultures were used for follow-up. Patients that continued having f-UTI, received redo-PIC cystography. PIC cystography was performed on 42 patients. The average age of patients was 8.0±3.6 years. Vesicoureteral reflux (VUR) was detected in 41 patients. Average follow-up time after PIC cystography was 44.6 months. Thirty-three patients (80.5%) were free of f-UTI after PIC cystography and concurrent subureteric injection. Eight patients continued to have recurrent f-UTI. Six of these patients underwent redo-PIC cystography and PIC-VUR was demonstrated in all patients. After an average follow up of 30.9 months, no f-UTI was seen in these patients. The success rate of 80.5% (33/41) after 1st PIC cystography and subureteric injection increased to 95.1% (39/41) after redo-PIC cystography in six patients. Patients with recurrent f-UTIs without VUR on VCUG are an important challenge. PIC cystography is an important tool in demonstrating occult VUR in these patients. We advise that PIC cystography is performed in all patients with recurrent f-UTI with negative VCUG and redo-PIC cystography in patients who continue to have f-UTI after 1st PIC cystography and subureteric injection. https://turkjpediatr.org/article/view/836Positional instillation of contrast cystographycystoscopyoccult VURurinary tract infectionvesico-ureteral reflux
spellingShingle Kıvılcım Karadeniz-Cerit
David Terence Thomas
Raziye Ergun
Nurdan Yıldız
Harika Alpay
Sabahat İnanir
E Tolga Dağlı
Halil Tuğtepe
Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral reflux
The Turkish Journal of Pediatrics
Positional instillation of contrast cystography
cystoscopy
occult VUR
urinary tract infection
vesico-ureteral reflux
title Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral reflux
title_full Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral reflux
title_fullStr Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral reflux
title_full_unstemmed Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral reflux
title_short Positional installation of contrast (PIC) and Redo-PIC cystography for diagnosis of occult vesicoureteral reflux
title_sort positional installation of contrast pic and redo pic cystography for diagnosis of occult vesicoureteral reflux
topic Positional instillation of contrast cystography
cystoscopy
occult VUR
urinary tract infection
vesico-ureteral reflux
url https://turkjpediatr.org/article/view/836
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AT raziyeergun positionalinstallationofcontrastpicandredopiccystographyfordiagnosisofoccultvesicoureteralreflux
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