TY - JOUR T1 - Endoscopic treatment of primary vesicoureteral reflux. JF - N Engl J Med Y1 - 2012 A1 - Pennesi, Marco A1 - L'erario, Ines A1 - Barbi, Egidio KW - Female KW - Humans KW - Ureteroscopy KW - Vesico-Ureteral Reflux VL - 367 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22762335?dopt=Abstract ER - TY - JOUR T1 - Managing children under 36 months of age with febrile urinary tract infection: a new approach. JF - Pediatr Nephrol Y1 - 2012 A1 - Pennesi, Marco A1 - L'erario, Ines A1 - Travan, Laura A1 - Ventura, Alessandro KW - Anti-Bacterial Agents KW - Child, Preschool KW - Female KW - Humans KW - Infant KW - Male KW - Pediatrics KW - Recurrence KW - Retrospective Studies KW - Urinary Tract Infections AB -

BACKGROUND: Recent guidelines on urinary tract infection (UTI) agree on reducing the number of invasive procedures. None of these has been validated by a long-term study. We describe our 11-years experience in the application of a diagnostic protocol that uses a reduced number of invasive procedures.

METHODS: We reviewed retrospectively the records of 406 children aged between 1 and 36 months at their first UTI. All patients underwent renal ultrasound (RUS). Children with abnormal RUS and those with UTI recurrences underwent voiding cystourethrography (VCUG) and dimercaptosuccinic acid (DMSA) renal scans.

RESULTS: RUS after the first UTI was pathological in 7.4% children; 4.4 % had a second UTI. We performed 48 VCUG: 14 patients (29%) had vesicoureteral reflux (VUR), 12 of which showed an abnormal RUS while 2 had recurrent UTI. After DMSA renal scan renal damage appeared in only 6 of them (12.5%); all these children showed grade IV VUR.

CONCLUSIONS: The application of our guidelines leads to a decrease in invasive examinations without missing any useful diagnoses or compromising the child's health.

VL - 27 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22234625?dopt=Abstract ER -