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Excretory urography and cystourethrography in the evaluation of children with urinary tract infection

R Drachman, M Valevici, P A Vardy

    Clinical Pediatrics
    |May 1, 1984
    PubMed

    Insights

    For children with a first urinary tract infection (UTI), voiding cystourethrography (VCU) is more effective than intravenous pyelography (IVP). VCU reveals significant anatomical abnormalities and vesico-ureteral reflux (VUR) in over 50% of cases.

    Area of Science:

    • Pediatric Nephrology
    • Diagnostic Imaging
    • Urology

    Background:

    • Urinary tract infections (UTIs) are common in children.
    • Accurate diagnosis and management are crucial to prevent renal scarring and long-term complications.
    • Radiological imaging plays a key role in evaluating the urinary tract after a UTI episode.

    Purpose of the Study:

    • To compare the diagnostic yield of intravenous pyelography (IVP) and voiding cystourethrography (VCU) in children with a first UTI.
    • To determine the incidence of anatomical abnormalities and vesico-ureteral reflux (VUR) in this population.

    Main Methods:

    • A retrospective study of 191 children with a first UTI.
    • All children underwent both IVP and VCU.
    • Analysis of findings from both imaging modalities, focusing on prognostic and therapeutic significance.

    Main Results:

    • Only 1.5% of IVPs showed significant positive findings.
    • VCU revealed anatomical abnormalities in 50.7% of children.
    • Vesico-ureteral reflux (VUR) was diagnosed in 40.3% of cases, with varying grades.

    Conclusions:

    • VCU is a more valuable investigation than IVP for identifying significant urinary tract abnormalities after a first UTI in children.
    • The high incidence of VUR and other abnormalities highlights the importance of VCU in guiding management and preventing complications.

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