Prevalence of Anatomical Anomalies in Pediatric Patients Hospitalized with UTIs in a Tertiary Care Center's Urology and Nephrology Ward

Abstract

Background: Urinary tract infections (UTIs) are a significant pediatric health concern, often linked to anatomical anomalies of the urinary tract. Understanding the prevalence and characteristics of these anomalies in children with UTIs is crucial for effective diagnosis and management. Objective: This study aimed to investigate the prevalence and nature of anatomical anomalies in children diagnosed with UTIs, focusing on age and gender distribution, and to identify common anomalies associated with UTIs in pediatric patients. Methods: A retrospective cross-sectional study was conducted at the Children's Medical Center in Tehran, from March to September 2022. The study included pediatric patients admitted with UTIs, excluding those over 18 years of age. Convenience sampling was used to target at least 70 patients with definitive anatomical anomalies. Data collection involved reviewing medical records and laboratory results, focusing on variables such as age, sex, paraclinical tests, and types of anatomical anomalies. Statistical analysis was performed using SPSS software version 25, employing Fisher’s exact or χ2 tests for categorical variables, and the student’s t-test, ANOVA, and Chi-Square tests for continuous variables. Results: The average age of patients was 29.61 months (SD = 35.28), with a median of 12.50 months (IQR = 36). The average number of UTI episodes was 3.43 (SD = 2.31), ranging from 1 to 10 episodes. Bilateral hydronephrosis was observed in 15 patients (21.7%), while neurogenic bladder and Reflux Grade 4 or 5 were identified in 11 (15.9%) and 14 (20.3%) patients, respectively. VCUG was performed in 63 patients (91.3%). Unilateral hydronephrosis was the most common imaging finding, observed in 33 patients (47.8%). Conclusion: The study concludes that children around 29 months of age, particularly females, are more prone to have anatomical anomalies associated with UTIs. Bilateral hydronephrosis was a prevalent anomaly. However, limitations such as potential data unavailability or misinterpretation, errors in laboratory data, and patient comorbidities must be considered when interpreting these findings.