Urine flow curve shapes in adults with earlier vesicoureteral reflux.

OBJECTIVES AND METHODS

Voiding problems related to childhood vesicoureteral reflux (VUR) in a cohort of 120 patients (109 females, 11 males) were studied at early middle age (range, 33-50 yr). Forty-four patients had been operated on. The study included an interview by means of a symptom questionnaire, a urine flow measurement, a residual urine measurement, and a urine sample.

RESULTS

The flow curve shape was abnormal in 40% (tower-shaped in 7%, weak in 18%, interrupted in 8%, and big bladder in 8% of patients). Forty-five percent of operated patients and 70% of nonoperated patients had a normal flow curve shape. Almost half of the operated patients (45%) had either an interrupted or a weak flow. Figures for stress incontinence and urgency incontinence among the female patients were twice those in the controls, 35% versus 16% (p=0.05) and 20% versus 11%, respectively. Urinary tract infections (UTIs) were diagnosed in 76% of the adult female VUR patients and in 57% of their controls (p=0.041). Twenty-five percent of the female VUR patients (none of the controls) reported suffering from UTI more often than once a year.

CONCLUSIONS

Adult patients with childhood VUR have abnormal urine flow curve shapes and UTIs significantly more often than controls (p=0.00005 and p=0.04, respectively). Patients who were operated on for VUR especially seemed to have an interrupted or weak flow curve shape. A high percentage of these patients also suffered from urgency and stress incontinence and annual UTIs.