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

Ivana Fratrić1,2, Dragana Milutinović1, Maja Samardžić Lukić1,2

  • 1Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.

Healthcare (Basel, Switzerland)
|July 12, 2025
PubMed

Insights

Voiding cystourethrography (VCUG) is a common diagnostic tool, but this study found that avoiding it for single urinary tract infections or non-specific indications can reduce unnecessary radiation exposure and complications in children.

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.

Keywords:
diagnostic imagingpediatric nephrologypediatric urologyradiation exposureurinary tract infectionvesicoureteral refluxvoiding cystourethrography

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