Bilater reflux with recurrent UTI - 6 years female child

Dear All,

6 years female child presented with history of recurrent febrile episodes in last 2 to 3 years period. 
She was diagnosed with febrile UTI first time before a month .
Her culture was positive for E. Coli and she was treated with injectable AB. At present she is on ab prophylaxis. 
S. Creatinine is 0.52 mg%
USG: Bilateral hun, more on left side. 
I am posting images of VAUG.
What next.  At present DMSA not available because of Covid 19.


  • Dr. Anil Takvani
    Dr. Anil Takvani
    03 Aug 2020 09:51:59 PM

    Uploading images of VCUG...

  • Utsav Shah
    Utsav Shah
    07 Aug 2020 09:33:01 PM

    Respected Sir,

    Based on the available images, VUR appears to be more on the right side

    Rt side- GrIII/IV
    Lt side- GrII/III

    DMSA will do justice to her. 
    But in case of non availability, we can continue her on oral AB prophylaxis.

    If she develops breakthrough infection, we can intervene(endoscopic or anti reflux Surg)

  • Rahul Kapoor
    Rahul Kapoor
    08 Aug 2020 02:16:06 PM


    I would like to intervene and do anti reflux surgery. 
    She is 6 years old, recurrent UTI and reflux even during filling phase

  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    09 Aug 2020 10:09:50 PM

    Sir,in this case,I want to know history of BBD n neurogenic bladder...

    Will keep her on AB prophylaxis...
    Mild laxative...
    Do MCUG after control my of infection in 4-6 weeks...then decide...
    For the time being infection control n bowel management..

  • Dr. Anil Takvani
    Dr. Anil Takvani
    09 Aug 2020 10:47:09 PM


    Why want to repeat MCU after few weeks?

  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    10 Aug 2020 11:42:29 PM

    Sir,how I see it as duplex kidney( have a look at rt sided image),with urinary tract infection...with inflammation...vuj junction r not that competent to not allow reflux of after control of inflammation,I want to repeat it..

  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    11 Aug 2020 09:17:35 PM

    Sir, kindly update the case

  • Dr. Roy Chally
    Dr. Roy Chally
    28 Aug 2020 10:14:39 AM

    Voiding film shows a narrowing in the sphincter area of urethra. The distal and proximal urethra a little dilated. Has she got urgency ? Cystometry if urge or urge wetting is present. 

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