The Lack of Correlation Between Upper Tract Changes on Excretory Urography and Significant Vesicoureteral Reflux

In a retrospective review of all excretory urograms and voiding cystourethrograms performed in a 1-year period in 391 children evaluated with a history of urinary infection 56 (14 per cent) had vesicoureteral reflux as well as a normal excretory urogram. Of the 89 children in the study with vesicoureteral reflux 56 (63 per cent) had a normal excretory urogram. The grade of reflux was II or greater in 49 per cent of the cases, which also had a normal excretory urogram. We conclude that an excretory urogram without a voiding cystourethrogram is an inadequate study for a child with a history of urinary infection.