Patient had several recent episodes of urinary tract infections. What is the best next step in management?
Initiation of prophylactic antibiotics and referral to urologist would be appropriate.
Pre-void contrast filled bladder demonstrated bilateral vesico-ureteral reflux (VUR) with mildly tortuous and moderately dilated ureters, with contrast reaching blunted dilated calyces (low pressure VUR)
After voiding, the collecting systems fill even further, compatible with a component of high pressure VUR.
Findings are keeping with bilateral type 4 vesico-ureteral reflux.