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Pediatric cystogram: Are we considering age-adjusted bladder capacity?

Luis A Guerra1,2,3, Melise A Keays1,2,3, M J Purser1

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Pediatric cystograms often overfill bladders, especially in infants, increasing risks of bladder rupture and misdiagnosis. Adhering to age-adjusted bladder capacity is crucial for accurate results and patient safety.

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Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging

Background:

  • Bladder rupture during cystography is rare but reported in children.
  • Overfilling of the bladder during cystograms is a potential concern.

Purpose of the Study:

  • To evaluate current practices in performing cystograms.
  • To compare the actual volume used to fill the bladder with age-adjusted bladder capacity in children.

Main Methods:

  • Retrospective review of voiding cystourethrograms (VCUG) and radionuclide cystograms (RNC) from 2006-2013.
  • Utilized established formulas to estimate age-adjusted bladder capacity for infants and older children.

Main Results:

  • A total of 2411 cystograms were analyzed.
  • Bladders were overfilled by 32% on average compared to age-adjusted capacity.
  • Infants showed a significant overfilling rate of 64% during VCUG.

Conclusions:

  • Children's bladders are frequently overfilled during cystograms, particularly infants.
  • This practice raises concerns for bladder rupture and potential overdiagnosis of vesicoureteric reflux.
  • Recommendations include adhering to age-adjusted bladder capacity and allowing adequate voiding time.