Timing of voiding cystourethrography in infants with first time urinary infection

Abstract

The aim of the study was to evaluate whether the timing of performing a voiding cystourethrography (VCUG) following a first urinary tract infection (UTI) in infants is related to the presence or the severity of vesicoureteral reflux (VUR). A total of 411 children (male 230, female 181) with a first-recognised UTI between ages 15 days and 12 months (median 3 months) underwent a VCUG within 4-81 days (median 9 days) following diagnosis. The presence and the grade of the VUR were compared in two groups: an "early" group in which the VCUG was performed during the first week of the start of treatment and a "late" group in which the examination was performed during the second week or thereafter. The prevalence of VUR in the study cohort was 23.3% (96/411 infants). A VUR was diagnosed in 44 infants in the early group (28%) and in 52 in the late group (21%). Reflux of grade III or higher was seen in 25/44 (57%) of the infants in the early group and in 27/52 (52%) infants in the late group. These differences were not significant. Our results suggest that neither the presence nor the grade of VUR in infants is influenced by the timing of the examination following diagnosis. We therefore recommend that it is better to perform VCUG as soon as possible, provided the inflammation has subsided.

Comparing between results and complications of doing voiding cystourethrogram in the first week following urinary tract infection and in 2-6 weeks after urinary tract infection in children referring to a teaching hospital

“…Mahant et al revealed that timing of VCUG did not influence the prevalence and severity of reflux during the first week and later ( 7 ). Results of other studies were in accordance with report of Mahant et al They recommended that VCUG should be conducted as soon as possible ( 6 , 10 - 13 ). Previous authors believes that VCUG should be done at the end of treatment, when discharging the patient from hospital ( 1 ).…”

Febrile urinary tract infections in young children: recommendations for the diagnosis, treatment and follow‐up

“…Cystourethrography (VCUG) remains the gold standard, permitting an exact grading according to the International Working Group on VUR in children (52), but because of its higher radiating dose, it should be limited to selected patients (in particular, to males in whom there is a suspicion of posterior urethral valves). The timing of cystourethrography can be established according to local organization and to family convenience, as there is evidence that neither the presence nor the grade of VUR is influenced by the timing of the examination following diagnosis of UTI (53–55) [grade B].…”

Sonocystografia mikcyjna 2D/3D/4D w diagnostyce i monitorowaniu leczenia odpływów pęcherzowo- -moczowodowych u dzieci – czy może zastąpić rentgenowską cystouretrografię mikcyjną?

“…The detected pathogens included: Escherichia coli, Proteus species, Pseudomonas aeruginosa, Staphylococcus species and Klebsiella pneumoniae . The examinations were performed no sooner than 2 weeks after the last urinary tract infection had been treated ( 7 ) .…”