Abstract
INTRODUCTION: Vesicostomy is a widely accepted urinary diversion procedure for pediatric patients with high-pressure bladders, such as those with vesicoureteral reflux (VUR) or neurogenic bladder (NB). This study aimed to investigate whether preoperative filling-phase VUR detected on voiding cystourethrography (VCUG) contributes to the recurrence of febrile urinary tract infections (fUTIs) following vesicostomy. MATERIALS AND METHODS: This retrospective study analyzed 27 patients who underwent vesicostomy between January 2019 and December 2024. Patients were categorized according to the presence or absence of postoperative fUTIs. Clinical parameters included sex, presence of filling-phase VUR, bladder compliance, detrusor overactivity, posterior urethral valve (PUV), and intrarenal reflux (IRR). Statistical analysis was performed using the chi-squared test, with significance set at p<0.05. RESULTS: Of the 27 patients (21 males, six females), 17 (62.9%) developed fUTIs postoperatively. Filling-phase VUR was observed in 20 patients, 15 of whom developed fUTIs, while only two of seven patients without filling-phase VUR experienced fUTIs (p=0.03). The odds ratio (OR) for filling-phase VUR was 7.50. Other factors, including bladder compliance, detrusor overactivity, PUV, and IRR, showed no significant association. CONCLUSION: Preoperative filling-phase VUR detected on VCUG is a significant risk factor for recurrent fUTIs following vesicostomy in children. Patients with filling-phase VUR may require closer follow-up and adjunctive management strategies to prevent postoperative infections.