<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 reflux o According to Nelson The most common abnormality seen in a child with UTI in a voiding cystourethrogram is vescioureteric reflux. It is identified in approximately 40 of patients. Vesicoureteric reflux VUR o Retrograde flow of urine from the bladder to the ureter and renal pelvis is referred to as vesicoureteric reflux. o VUR is the source of UTI in 30 to 50 of children. o Recurrence occurs in about 3090 of boys and 40 of girls. o Recurrences nearly always occur within the first six months after the first UTI. o Vesicoureteric reflex may be primary or secondary. 1 Causes of primary VUR a Due to developmental ureterotrigonal weakness b Associated with other ureteral anomalies such as ectopic orifice or ureterocele. 2 Causes of secondary VUR a Bladder outlet obstruction c Neuropathic dysfunction e Inflammation b Urethral obstruction d Iatrogenic f Tubercular infection 