When is voiding cystourethrography (VCUG) used 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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Traditionally, VCUG has been recommended for infants and children after a first febrile UTI. This is based on assumptions that most upper UTIs occur because of urinary bladder infection and that vesicoureteral reflux (VUR) transfers bacteria in the bladder to the kidney. However, scintigraphic studies have shown that many children with pyelonephritis have no evidence of VUR. [3, 37]

VCUG is indicated if renal and bladder ultrasonography reveals hydronephrosis, scarring, or other findings that suggest either high-grade VUR or obstructive uropathy. VCUG should also be performed if a patient has a recurrence of a febrile UTI, even if previous ultrasonographic examination findings were unremarkable. [3]

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