The risk factors for recurrence of febrile urinary tract infection and renal scarring in children with functional urinary incontinence

Objectives Functional urinary incontinence is often associated with recurrent urinary tract infection (UTI), vesicoureteral reflux (VUR), and renal scarring. This study aims to evaluate the correlations between urodynamic findings and recurrence of UTI, VUR, and renal scarring in children with functional incontinence. Methods In this retrospective observational study, data on the presence of VUR, urodynamics and 99Tc-dimercaptosuccinic acid scintigraphy findings, and episodes of febrile UTI were obtained from patients & apos; records. The patients had at least 3 years of follow-up. Results There were significant associations between recurrence of UTI and decreased bladder capacity (hazard ratio: 1.321,P= .028). The receiver operator characteristic curve analysis showed a cutoff value for compliance of 13.25 mL/cmH(2)O for renal scarring (P= .000). There was a significant association between bladder wall thickening and VUR (odds ratio: 2.311,P= .008). The compliance had a cutoff value of 14.7 mL/cm H2O (P= .023) for severe VUR. The frequency of renal scarring was higher in patients with severe VUR and dysfunctional voiding (P= .001 andP= .041, respectively). The independent risk factors for renal scarring were low compliance, severe VUR, and dysfunctional voiding in children with functional incontinence, but recurrence of febrile UTI was not a risk factor for renal scarring. Decreased bladder capacity was a risk factor for recurrence of febrile UTI. Conclusions The present study suggests that low compliance, severe VUR, and dysfunctional voiding, but not the recurrence of febrile UTI, are the independent risk factors for renal scarring in children with functional incontinence, and decreased bladder capacity is the risk factor for the recurrence of febrile UTI.