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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
PubMed

Insights

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.
Abstract

Keywords:
antibiotic prophylaxiscomplicationsurinary tract infectionvesicoureteral refluxvoiding cystourethrography

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