Does the Timing of a Micturating Cystourethrogram (Mcug) Following a Febrile Uti in Infants Affect Detection of Ureterovesical Reflux?

Abstract

Purpose The investigation of infantile febrile urinary tract infection (UTI) is still a subject of debate and controversy. To evaluate for ureterovesical reflux (VUR) most authorities recommend a micturating cystourethrogram (MCUG) to be performed at least 4 weeks after the UTI to avoid false positive results. We reviewed our 10 year experience to determine whether the timing of MCUG affected the detection of ureterovesical reflux in this patient population. Material and Methods Information on 427 infants under 1 year of age who had undergone MCUG following a first febrile UTI was reviewed. The infants were divided in two groups: Group A (117) with MCUG performed within 4 weeks from UTI diagnosis and Group B (310) with MCUG at least 8 weeks from diagnosis. Results Of the 427 children, there were 258 boys (60%) and 169 girls (40%) with a median age of 5.2 months (1-12). VUR was detected in 33% of those for whom MCUG was performed 4 weeks after UTI diagnosis and in 24% of those for whom it was performed at least 8 weeks after diagnosis (p = 0.07). The grade of VUR in these two groups was not statistically significant (p = 0.3) Conclusions Neither the prevalence nor the grade of VUR in infants with a first episode of UTI is influenced by the timing of the MCUG. Following treatment of the acute episode and complete resolution of symptoms the MCUG can be performed as soon as is convenient.