<prompt> The most common underlying anomaly in a child with recurrent urinary tract infections is:Posterior urethral valvesVesicoureteric refluxNeurogenic bladderRenal calculi  <response>: Ans. is b i.e. Vesicoureteric refluxRef. O.P. Ghai 6the p457 5the 374, 375, Nelson 17the, p 1790-1794 16the page 1624, 1636According 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 andor 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 