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Low Risk for Urinary Tract Infection After Voiding Cystography in Children Without Dilated Vesikoureteral Reflux
Emelie Widhe1, Mette Hambraeus1,2, Erik Hedström3,4
1Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden.
Acta Paediatrica (Oslo, Norway : 1992)
|December 29, 2025
Summary
Urinary tract infections (UTIs) after voiding cystourethrography (VCUG) are uncommon in children. However, children with dilating vesicoureteral reflux (VUR) face an increased risk, suggesting a need for targeted interventions.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Radiology
Background:
- Urinary tract infections (UTIs) are a common complication following voiding cystourethrography (VCUG) in children, with highly variable reported incidence.
- Identifying risk factors for post-VCUG UTIs is crucial for preventing complications.
Purpose of the Study:
- To evaluate the incidence and identify risk factors for UTIs occurring after VCUG in pediatric patients.
Main Methods:
- A multicenter retrospective cohort study included 1001 children under 15 years old who underwent VCUG between 2017 and 2022.
- UTIs (lower UTI/cystitis and febrile UTI/pyelonephritis) within 14 days of VCUG were recorded, confirmed by clinical assessment and positive urine culture.
Main Results:
- The overall incidence of post-VCUG UTI was 3.4% (34 children), with 60% occurring within 7 days and 88% being febrile.
- Children with dilating vesicoureteral reflux (VUR) showed a significantly increased risk of post-VCUG UTI (adjusted odds ratio 5.4).
- Pathological findings, including VUR (83%), were present in 47% of the children.
Conclusions:
- The rate of UTIs following VCUG in children is low.
- Dilating VUR is a significant risk factor for post-VCUG UTIs, and targeted interventions in this group may reduce further infections and prevent chronic kidney injury.
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