Evaluation of Timing of Voiding Cystourethrogram after Urinary Tract Infection

ABSTRACT

PURPOSE: Urinary tract infection is a common problem in children. To evaluate for reflux most authorities recommend a voiding cystourethrogram 3 to 6 weeks after the first urinary tract infection. But during the 3 to 6 weeks interval, patients may fail to show up for the scheduled VCUG and thus risk for loss of follow up. We analyzed patient's records to evaluate whether the timing of VCUG after UTI influenced the prevalence or severity of VUR. METHODS: We retrospectively reviewed 213 children diagnosed with UTI from March 1997 to December 2000. These children were divided into 2 groups according to whether they had VCUG scheduled to be performed either within 1 weeks after the diagnosis of UTI (Group A) or later than 1 week after the diagnosis(Group B). We compared the presence and severity of reflux in the 2 groups. RESULTS: Reflux was present in 19% of the patients studied within 1 week after UTI and in 18% of those studied after 1 week. This difference was not statistically significant. Whereas 100% of the scheduled VCUGs in the Group A were performed, only 48% of those scheduled in the Group B were performed. This difference is statistically significant. CONCLUSION: Because there was no significant difference between the presence or severity of reflux and timing of VCUG after UTI, we suggest that a hospitalized patient with UTI should have VCUG performed before discharge.