Related Experiment Video
Updated: Jan 20, 2026
Transurethral Induction of Mouse Urinary Tract Infection
Published on: August 5, 2010
Timing of voiding cystourethrography after febrile urinary tract infection in children: a systematic review
Sara Mazzi1, Katharina Rohner2, Wesley Hayes3,4
1Paediatrics, University Children's Hospital Zurich, Zurich, Switzerland.
Insights
Early voiding cystourethrography (VCUG) after febrile urinary tract infection (fUTI) in children does not impact vesicoureteric reflux (VUR) detection rates. Performing VCUG within 8 days of antibiotic therapy shows no significant difference in VUR prevalence compared to later imaging.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Evidence-Based Medicine
Background:
- Febrile urinary tract infections (fUTI) in children often lead to imaging investigations.
- Current clinical guidelines lack specific recommendations on the optimal timing for voiding cystourethrography (VCUG).
- Practice patterns for VCUG timing post-fUTI vary significantly among clinicians.
Purpose of the Study:
- To determine if the detection rate of vesicoureteric reflux (VUR) in pediatric patients is influenced by the timing of VCUG after initiating antibiotic therapy.
- To provide evidence-based insights into the optimal timing for VCUG following fUTI in children.
Main Methods:
- A systematic review and meta-analysis of studies published up to November 2018.
- Inclusion criteria: pediatric patients (<18 years) undergoing VCUG after fUTI and antibiotic therapy, with reported VUR detection rates.
- Comparison of VUR prevalence between early (≤7 days) and late (≥8 days) VCUG procedures post-antibiotic onset.
Main Results:
- Nine studies involving 1745 patients were analyzed.
- No significant difference in the overall prevalence of VUR was found between early and late VCUG groups (Risk Ratio 0.98, 95% CI 0.81-1.19).
- Stratified analysis by VUR grade also revealed no significant differences between the timing groups.
Conclusions:
- Performing early VCUG (within 8 days) after the onset of antibiotic therapy for fUTI in children does not alter the prevalence of detected VUR.
- The findings suggest that current early imaging trends may not be critical for VUR detection rates.
Background:
Despite a trend towards early voiding cystourethrography (VCUG) after febrile urinary tract infection (fUTI) in children, clinical guidelines do not comment on the optimal timing and current practice varies considerably.
Objective:
To assess whether the detection rate of vesicoureteric reflux (VUR) in children depends on the time period of VCUG procedure after onset of antibiotic therapy.
Methods:
MEDLINE, EMBASE and Cochrane Controlled Trials Register electronic databases were searched for eligible studies without language or time restriction (19 November 2018). Inclusion criteria were (1) patients <18 years of age; (2) VCUG performed in patients with fUTI after onset of antibiotic therapy either in the same patient population or in two or more different patient populations within one study at different time periods; and (3) with reported detection rate of VUR. The systematic review was carried out following the recommendations of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Results:
Of 4175 records, nine studies were included (number of patients, n=1745) for the main outcome prevalence of VUR by VCUG <8 days compared with VCUG ≥8 days after onset of antibiotic therapy. Pooled overall prevalence of VUR was not significantly different between the early and the late VCUG groups (risk ratio 0.98, 95% CI 0.81 to 1.19). Prevalence of VUR stratified by grade was not significantly different between the two groups.
Conclusion:
Early VCUG within 8 days after onset of antibiotic therapy does not affect the prevalence of VUR.
Trial Registration Number:
CRD42018117545.
Related Concept Videos
09:24Transurethral Induction of Mouse Urinary Tract Infection
07:57An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
02:53Generating Urinary Tract Infection Model: A Technique to Administer Uropathogenic Bacteria in Mouse to Develop Urinary Tract Infection Model
05:25Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing
02:54Establishment of a Urinary Tract Infection Model in Female Mice
01:26Urinary Tract Infection I: Introduction