Timing of voiding cystourethrography in infants with first time urinary infection

Area of Science:

• Pediatric Nephrology
• Urology
• Diagnostic Imaging

Background:

• Urinary tract infections (UTIs) are common in infants.
• Vesicoureteral reflux (VUR) is a significant risk factor for recurrent UTIs and renal scarring.
• The optimal timing for voiding cystourethrography (VCUG) after a first UTI in infants remains debated.

Purpose of the Study:

• To determine if the timing of VCUG following a first UTI in infants influences the diagnosis or severity of VUR.
• To compare VUR prevalence and grade based on early versus late VCUG performance.

Main Methods:

• A cohort of 411 infants (15 days to 12 months) with a first UTI underwent VCUG.
• Infants were categorized into 'early' (within 7 days) and 'late' (after 7 days) VCUG groups.
• VUR presence and grade (International Classification of Renal Unit) were analyzed between groups.

Main Results:

• Overall VUR prevalence was 23.3%.
• No significant difference in VUR presence (28% early vs. 21% late) or grade (57% grade III+ early vs. 52% late) was observed between groups.
• The timing of VCUG did not impact VUR detection or severity.

Conclusions:

• The timing of VCUG after a first infant UTI does not affect the identification or grading of VUR.
• Performing VCUG as soon as feasible after UTI diagnosis, once inflammation resolves, is advisable.
• This approach may expedite VUR diagnosis and management decisions.