Timing of voiding cystourethrogram in the investigation of urinary tract infections in children

Abstract

Objective: To determine whether the detection of vesicoureteral reflux (VUR) in children with a urinary tract infection (UTI) is more likely if the voiding cystourethrogram (VCUG) is performed early (within the first 7 days after diagnosis) or late (>7 days after diagnosis). Study design: We conducted a retrospective case review of children <5 years of age admitted with a first episode of UTI to a tertiary care pediatric hospital over a 2-year period. Timing of the VCUG was at the discretion of the attending pediatrician. Differences in age, sex, mean time to performing the VCUG, and incidence of VUR between the 2 groups (VCUG performed early vs late) were compared by using Student t test (for age) and χ2 test (for sex and incidence of VUR). Potential confounders (age and sex) were included in a multiple logistic regression analysis. Results: A total of 162 patients were eligible for inclusion. Mean age was 181 days, and 43.8% were female. The incidence of VUR was 21.6%. The early group consisted of 82 patients, and the late group consisted of 80. No significant difference was found for age or sex or for the incidence of reflux (17.1% vs 26.3%, P = .219), with a crude odds ratio of .59 (95% CI 0.3-1.2, P > .05). Conclusion: The rate of detection of VUR in children with a first episode of UTI does not increase when the VCUG is done early (within the first 7 days of diagnosis) rather than later. (J Pediatr 2001;139:568-71)