- Ideally, a study would compare VCUG's performed on the same
children at <4-6 weeks after positive urine culture, and >4-6
weeks after the positive culture in order to create a comparison to
a "gold" standard to prove whether or not timing of the VCUG
makes a difference in detection of vesicoureteral reflux. However,
due to the invasive nature of the VCUG, that was not deemed feasible
by the authors of this study.
- The children in this study who had the VCUG within one week after
diagnosis were more likely to show vesicoureteral reflux, and of a higher
grade, but this result is difficult to interpret due to the exceedingly
small sample size. These results show that beyond one week after
diagnosis of UTI, there is no evidence of an association between the
presence or grade of reflux and the timing of VCUG.
- Deferring VCUG for 4-6 weeks after starting antibiotic therapy may
cause undo parental anxiety surrounding the uncertainty of the diagnosis,
and the child will have to remain on prophylactic antibiotics until
the test is performed. There is also the potential for increased
compliance if the test can be scheduled earlier in conjunction with
the renal imaging studies.
- Author. Vesicoureteric Reflux and Timing of Micturating Cystourethography
after Urinary Tract Infection. Archives of Disease in Childhood,
- See also the role of ultrasound in the diagnosis