The most common underlying anomaly in a child with recurrent urinary tract infections is:

Ans. is 'b' i.e. Vesicoureteric refluxRef. O.P. Ghai 6th/e p457 (5th/e 374, 375), Nelson 17th/e, p 1790-1794 (16th/e page 1624, 1636)According to Nelson "the most common abnormality seen in a child with UTI in a voiding cystourethrogram is vesicoureteric reflux. It is identified in approximately 40% of patients".Some students were in favour of posterior urethral valves. Make it clear that the chief complain of posterior urethral valve is not UTI but poor urinary stream. Posterior urethral valve mainly presents with obstructive uropathy.Also rememberGrade I: reflux into a nondilated ureter.Grade II: reflux into the upper collecting system without dilatation.Grade III: reflux into dilated ureter and/or blunting of calyceal Fornices.Grade IV: reflux into a grossly dilated ureter.Grade V: massive reflux, with significant ureteral dilatation and tortuosity and loss of the papillary impression.Grading of Vesico ureteral reflux