The prevalence of vesicoureteral reflux (VUR) among siblings of children with VUR has been reported to be from 4.7% to 51%. The incidence of VUR in the general population is less than 1% but it is high in risk groups. In a prospective study we started identifying the incidence and severity of VUR and renal parenchymal lesions in the siblings of patients known to have urinary tract infection (UTI) with reflux. Between October 1994 and February 2002, 31 siblings of 26 index patients were screened with direct voiding cystography. Technetium -99m dimercaptosuccinic acid (DMSA) nuclear renal scans were performed in siblings with VUR to detect renal scarring. The cystograms were interpreted as showing the presence or absence of VUR and the DMSA scan as symmetrical or asymmetrical differential function, with or without renal scar.Sixteen of 31 siblings were found to have vesicoureteral reflux representing an incidence of 51.61%. Mean age at presentation of the 8 boys and 23 girls was 2.5 years (range 6 months to 12 years). The majority of them were asymptomatic. reflux was unilateral in 11 siblings and bilateral in 5. Of 16 siblings with reflux, 6 (37.5%) had a history of symptomatic UTI. The frequency of VUR was equal in siblings over 6 years and those younger. Fifteen of the 16 siblings with VUR had DMSA scintigraphy, of whom 5 were normal and 10 (66.66%) showed abnormalities (nine asymmetrical differential function and one parenchymal defect), which was bilateral in 7 and unilateral in 3. This study confirms a significant overall incidence of VUR in the siblings of patients with known reflux. The prevalence of reflux in older siblings is similar to those in the younger ones. The high rate of reflux in this population, especially girls, over 6 year old might be attributed to bladder dysfunction

Introduction. vesicoureteral reflux (VUR) has been known to be a risk factor for urinary system of infants and children with urinary tract infection. It can induce permanent adverse effect such as scar, hypertension, and ongoing declining renal function. DMSA renal scan is still a main pointer of acute and chronic damages of kidneys due to VUR. Other unsuccessful attempts including measuring interleukin-6 (IL-6), tumor necrosis factor (TNF)-alpha, and soluble TNF receptor-1 have been done to eliminate its invasive and expensive undesirable effect. The aim of this study was to determine and compare urine mean microalbumin and creatinie and their ratio between 3 groups of 2 to 10- year-old children affected by and recovered from reflux in comparion with normal matched age group. Methods. In this cross-sectional study, thirty-three 2- to 10-year children without UTI during the last 3 months, whose reflux or recovery had been diagnosed by VCUG or DRNC, were divided into 2 groups of 16 children affected by reflux, 17 recovered from reflux, and 18 matched normal children groups. Then, the point urine specimens were collected with permission of their parents in a single laboratory, and urine microalbumin (MA) and creatinine (Cr) for each specimen were measured. Alb/Cr ratio was calculated for each child to evaluate Alb excretion from urine possible without collecting 24-hours urine. MA/Cr ratio mean and MA were compared between the groups. To analyze our data, one way ANOVA test was used.Results. A total of 51 children, included 16 children affected by reflux, 17 recovered from reflux, and 18 normal children were entered to our study. The mean of MA/Crea and MA were 5.039±4.737 and 19.68±13.42 in affected group, respectively, 0.118 ± 0.187 in recovered group and 20.66 ± 12.5 in normal group. There was not a significant statistical difference between the 3 groups for MA and MA/Cr. Conclusion. Urine mean micro-albumin and its ratio with creatinine did not have any difference in children with reflux, with improved urinary reflux, and normal age matched group.

In 1964, Pfeiffer described an acrocephalosyndactyly syndrome consisting of bicoronal craniosynostosis, midface hypoplasia, broad thumbs, broad big toes, and partial and variable soft-tissue syndactyly of the hands and feet.(1) Autosomal dominant inheritance with complete penetrance is the main characteristic despite variable expressivity related to the presence or absence of syndactyly and its degree of severity. Based on the severity of the phenotype, Cohen proposed a classification of Pfeiffer syndrome into 3 clinical subtypes.(2) We report, a case of Pfeiffer syndrome type 2 with high-grade bilateral vesicoureteral reflux (VUR), and discuss the importance of surveillance for urogenital problems in patients with this syndrome….

vesicoureteral reflux (VUR) still remains one of the most common causes of severe renal damage or sometimes end-stage kidneys in children. Although in some cases prenatal suggestion may happen, especially in secondary VUR, most of them are detected during childhood after episodes of urinary tract infection.Despite new modern imaging modalities in the recent years, standard VCUG still has an important role in the evaluation of voiding dysfunction, primary and secondary VUR.Particularly in male children it is mandatory for the evaluation of lower urinary tract.This article is a review that describes the proper technique of VCUG, normal variations and some common pathological findings in secondary VUR.

Introduction: Dextranomer/hyaluronic (Dx/HA) acid is the only tissue-augmenting agent approved by the Food and Drug Administration (FDA) for the vesicoureteral reflux (VUR) treatment. Objectives: We aimed to evaluate short-term outcomes of the Dx/HA in patients who had undergone subureteric injection. Patients and Methods: In this study, 30 patients with VUR diagnosis who had indications for open surgery were enrolled in the study. Patients underwent subureteric Dx/HA injection. Additionally patients underwent a one-year follow up period, subsequently. Follow up included urine analysis, urine cultures and kidney and urinary tract ultrasonography study. Results: Of a total 30 patients, 8 patients (27%) were male and 22 patients (73%) were female. The mean age of patients was 25. 19 ± 0. 70 months. Postoperative VUR resolution was observed in 28 patients (93. 3%). Moreover, during one year follow up, urinary tract infection (UTI) was not reported in patients. However, recurrent VUR was detected in 8 patients (27%) during ultrasonography follow up. Analysis showed no significant difference of recurrence in VUR between males and females (P = 0. 285) and VUR severity (P = 0. 1). There was a significant relationship between recurrent UTI history before intervention and VUR recurrence after subureteric injection (P = 0. 007). Conclusion: Dx/HA acid subureteric injection provides acceptable resolution rate among VUR patients, but its biodegradability causes VUR recurrence during one-year follow up.

Objectives: The polygenic mode for inheritance of vesicoureteral reflux (VUR) is a debutable issue. Our study is aimed to investigate the correlation between HLA system and VUR. Materials: The study included thirty patients with VUR and sixty patients from kidney donors as control group. Initially the HLA formulas of each patient were detected according to racialgeographical distribution as well as common and specific antigens. Then, the Relative Risk (RR) for the class I antigens of the HLA system was calculated and the X2 statistical test was performed for the antigens with RR>1 to establish a significant association between HLA system and VUR.Results: Increased frequency of the genes HLA-A9, HLA-B44 were characterized by statistical analysis (RR>1, X2>3.84). Therefore, the significant correlation was found between VUR and HLA system (P<0.05).Conclusion: There are significant correlation between VUR and HLA-A9 and HLA-B44. However, more study is necessary that these genes may become markers for VUR.