Evaluation of sacral dimple association with urodynamic findings in children with recurrent urinary tract infection

Abstract

Introduction: Urinary tract infections (UTIs) are among the most important diseases of children. UTI timely diagnosis and treatment is essential to prevent renal failure. Objectives: This study aims to investigate the association of sacral dimples with recurrent UTIs and urodynamic findings in a group of pediatric patients. Patients and Methods: This case-control study was conducted on children aged one month to fifteen years old with recurrent UTIs. The association of sacral dimples with recurrent UTIs and urodynamic findings were studied. Results: In total, 229 patients with recurrent UTIs were recruited. One hundred thirty-one patients were in the case group (with sacral dimple), and 98 patients were in the control group (without sacral dimple). One-hundred and nine children (82.2%) in the case group and 56 children (57.1%) in the control group had abnormal voiding cystourethrography (VCUG) (P<0.001). Forty patients in the case group and 29 patients (29.6%) in the control group had abnormal dimercaptosuccinic acid (DMSA) scan in the first study (P=0.568). Twenty-two patients (16.8%) in the case group and 13 patients (13.3%) in the control group had renal scarring (P=0.578). Urodynamic findings were abnormal in 117 children (89.3%) in the case group and 70 children (71.4%) in the control group (P=0.001, OR=3.34, 95% CI: 1.65-6.78). Conclusion: In this study, abnormal uroflowmetry and bladder compliance were significantly more common in children with recurrent UTIs with sacral dimple in comparison to recurrent UTIs in patients without sacral dimple. It is recommended that in cases of sacral dimples, patients should undergo a urodynamic study to detect bladder dysfunction.