When is voiding cystourethrography (VCUG) indicated in the workup of pediatric urinary tract infection (UTI)?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Performance of voiding cystourethrography (VCUG) after a first febrile UTI may be indicated if renal and bladder ultrasonography reveal hydronephrosis, scarring, obstructive uropathy, or masses or if complex medical conditions are associated with the UTI. Informed consent and preferences of the patient’s parents or caregivers are considered.

Children who respond to treatment for a UTI but afterwards demonstrate an abnormal voiding pattern may need to undergo an evaluation for voiding dysfunction. This evaluation may include standard VCUG.

VCUG is also recommended after a second episode of febrile UTI. [3] There is some concern, however, that without VCUG after the first documented febrile UTI, some cases of significant reflux disease will be missed. [31]

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