Reassessing the Use of VCUG in Pediatric UTIs: Are We Overusing an Invasive Diagnostic Tool?

Area of Science:

• Pediatric Nephrology
• Pediatric Urology
• Diagnostic Imaging

Background:

• Voiding cystourethrography (VCUG) is the standard for diagnosing vesicoureteral reflux but is invasive and involves radiation.
• Identifying criteria to reduce unnecessary VCUGs is crucial for patient safety.

Purpose of the Study:

• To analyze factors influencing Voiding cystourethrography findings in pediatric patients.
• To identify opportunities for reducing unnecessary VCUG examinations.

Main Methods:

• Retrospective analysis of 197 pediatric patients undergoing VCUG.
• Statistical analysis including Mann-Whitney U test, chi-square test, and binary logistic regression.

Main Results:

• No significant age difference was found between normal and pathological VCUG findings.
• Patients with single UTIs or other indications had a higher likelihood of normal VCUG results.
• Pediatric urologists referred patients more selectively for VCUG compared to pediatric nephrologists.

Conclusions:

• Selective referral for VCUG, particularly by pediatric urologists, can decrease unnecessary procedures.
• Avoiding VCUG for single UTIs or non-specific indications minimizes radiation exposure and potential complications.