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Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
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Is exceeding estimated bladder capacity during voiding cystourethrograms harmful?

Robert M DeFlorio1, Monica S Epelman2, Kimberly Christnacht3

  • 1Department of Radiology, Nemours Children's Health, Jacksonville, FL 32207, United States.

The British Journal of Radiology
|December 2, 2025
PubMed
Summary
This summary is machine-generated.

Current guidelines often underestimate children's bladder capacity during voiding cystourethrogram (VCUG). Exceeding these estimates appears safe, with no adverse effects observed in this study.

Keywords:
bladderchildrenurodynamicsvesicoureteral refluxvoiding cystourethrogram

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Area of Science:

  • Pediatric Radiology
  • Urology
  • Diagnostic Imaging

Background:

  • Pediatric bladder capacity estimation is crucial for voiding cystourethrogram (VCUG) procedures.
  • Existing formulas, such as those from the American Academy of Pediatrics (AAP), are used to determine expected bladder volumes.
  • Overdistention during VCUG may lead to complications, necessitating adherence to established guidelines.

Purpose of the Study:

  • To compare actual bladder capacity during VCUG with formula-derived estimates in children.
  • To evaluate the safety of bladder overdistention during VCUG procedures.

Main Methods:

  • Retrospective review of 884 consecutive VCUG procedures over three years.
  • Exclusion of cases with conditions affecting bladder capacity (e.g., neurogenic bladders, vesicoureteral reflux).
  • Analysis of bladder volumes in 440 normal VCUG procedures.

Main Results:

  • Bladder volumes exceeded AAP/American College of Radiology estimates in 65% of VCUGs.
  • Overdistention occurred in 63% of VCUGs for children under 2 years and 68% for those aged 2-14 years.
  • No adverse effects were noted even when contrast volume exceeded 2x or 3x AAP estimates.

Conclusions:

  • Current guidelines frequently underestimate pediatric bladder capacity.
  • Exceeding established bladder capacity estimates during VCUG appears safe and without complications.
  • Findings suggest a potential need to revise current guidelines for bladder volume estimation in children.