Abstract
BackgroundVoiding cystourethrography (VCUG) is used to diagnose vesicoureteral reflux (VUR); however, it is an invasive procedure and can be psychologically distressing. Procedural sedation is occasionally utilized to alleviate anxiety during VCUG, and some patient populations may get referred more readily for sedation than others. Sedative medications may also impact the results of the test due to their effects on smooth muscle. The goals of this study were to compare patient characteristics between those that were referred for procedural sedation and those that were not and to compare VCUG results between sedated and non-sedated patients.MethodologyWe performed a retrospective cohort study of patients aged 2-18 years undergoing VCUG during a five-year period. Sedated patients were matched with non-sedated patients controlling for referring provider and procedure year. Exclusion criteria included chronic catheterization, same-day surgery, current intensive care admission, and sedation restrictions. A total of 284 patients were included. Demographic information, medical comorbidities, and VCUG results were analyzed.ResultsThere were no significant differences between sedated and non-sedated patients in any demographic variables. Neurologic, developmental, and gastrointestinal comorbidities were more common in sedated patients. On multivariate analysis, having more than one comorbid condition was the only significant predictor of referral for procedural sedation. There were no significant differences in VCUG results between sedated and non-sedated patients.ConclusionsPatients with comorbidities were more likely to receive procedural sedation for VCUG. Procedural sedation did not have a significant impact on test results, suggesting its potential utility in relieving pain and anxiety associated with VCUG.
Highlights
There were no significant differences in Voiding cystourethrography (VCUG) results between sedated and non-sedated patients
Procedural sedation did not have a significant impact on test results, suggesting its potential utility in relieving pain and anxiety associated with VCUG
Vesicoureteral reflux (VUR) is a relatively common pediatric diagnosis with an uncertain natural course, it can lead to recurrent urinary tract infections (UTI) and subsequent renal scarring
Summary
Vesicoureteral reflux (VUR) is a relatively common pediatric diagnosis with an uncertain natural course, it can lead to recurrent urinary tract infections (UTI) and subsequent renal scarring. VCUG is an invasive medical procedure and can be a painful and distressing psychological experience for patients and parents for various reasons [2]. Children are asked to void in unnatural environments amid unfamiliar individuals, creating further stress, anxiety, and apprehension which may predispose them to avoidable healthcare behaviors in adulthood [4,5]. To alleviate these concerns, procedural sedation has been utilized in this patient population. Employing deep sedation during VCUGs remains controversial as smooth muscle relaxing sedative medications may negatively impact voiding dynamics by. The goals of this study were to compare patient characteristics between those that were referred for procedural sedation and those that were not and to compare VCUG results between sedated and nonsedated patients
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