Pediatrics(구연) MP Session Ⅱ (MP-018) Geumkang Hall (Avenue 2F) 11월 28일(수) 17:00-18:00 방광요관역류 환자에서 배뇨방광요도조영술 중 지연된 요관내 조영제 배출이 돌파성 요로감염의 위험인자인가? ¹경북대학교 의학전문대학원 비뇨의학과교실 ²경북대학교병원 비뇨의학과 ³칠곡경북대학교병원 비뇨의학과 오정석², 하헌², 강준구³, 정재욱³, 하윤석², 최석환¹·², 이준녕¹·³, 김범수¹·², 김현태¹·³, 김태환¹·³, 유은상¹·², 권태균¹·³, 정성광¹·² Background and purpose: Vesicoureteral reflux (VUR) is a known risk factor for pyelonephritis, which may lead to renal scarring. Urinary stasis may provide an opportunistic environment for bacterial multiplication and is known as a risk factor for urinary tract infection (UTI). Despite several studies, there is a controversy regarding the implication of delayed contrast drainage on voiding cystourethrogram (VCUG) for breakthrough UTI in children with primary VUR. Therefore, we assessed the impact of the delayed contrast drainage on breakthrough UTI in children with primary VUR. Materials and Methods: We retrospectively reviewed the medical records of 108 children with primary VUR who underwent continuous antibiotics prophylaxis as initial treatment plan during January 2007 and December 2015. Delayed contrast drainage was defined as increased or no contrast drainage at voiding phase of VCUG. We allocated children to a delayed contrast drainage group or a normal contrast drainage group based on the upper tract drainage of contrast on VCUG. We evaluated patient demographics and clinical outcomes according to the delayed contrast drainage on VCUG. Multivariate analysis was used to identify the predictive factors for breakthrough UTI. Results: Of the 108 children, delayed contrast drainage was observed in 59 patients (54.6%). Breakthrough UTI was observed in 41 (38.0%) of all children. Although the initial VUR grade and bilaterality in the delayed contrast drainage were significantly higher than those in the normal contrast drainage group (p = 0.005 and 0.006, respectively), breakthrough UTI did not differ by contrast passage status (p = 0.415). Multivariate analysis showed that VUR grade (HR = 2.066, 95% CI =, 1.064-4.010) was significant predictor of breakthrough UTI. In addition, delayed contrast drainage was not a significant predictor of breakthrough UTI. Conclusions: Although the delayed contrast drainage was associated with high grade VUR and bilaterality, it was not observed as a risk factor for breakthrough UTI in children with primary VUR receiving continuous antibiotics prophylaxis. keywords : vesicoureteral reflux, Breakthrough UTI, Delayed contrast passage