Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children

Int J Urol. 2019 Feb;26(2):160-171. doi: 10.1111/iju.13881. Epub 2018 Dec 19.

Abstract

Voiding cystourethrography is the most important fluoroscopic examination in pediatric urology for the investigation of lower urogenital tract diseases, such as vesicoureteral reflux or urethral stricture. However, this invasive procedure imposes a significant burden on children and their parents, and recently there has been a paradigm shift in the diagnosis and treatment of vesicoureteral reflux. In the 2011 revision, the American Academy of Pediatrics guidelines on urinary tract infection recommended abandoning routine voiding cystourethrography after the first febrile urinary tract infection. In 2014, the randomized intervention for children with vesicoureteral reflux study recommended discontinuation of routine continuous antibiotic prophylaxis for vesicoureteral reflux. The time is now ripe to radically reconsider indications for voiding cystourethrography and the procedure itself.

Keywords: child; vesicoureteral reflux; voiding cystourethrography.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anxiety / etiology
  • Anxiety / psychology
  • Child, Preschool
  • Cystography / adverse effects*
  • Cystography / methods
  • Cystography / psychology
  • Fluoroscopy / adverse effects
  • Fluoroscopy / methods
  • Humans
  • Infant
  • Male
  • Postoperative Complications / etiology*
  • Postoperative Complications / psychology
  • Practice Guidelines as Topic
  • Societies, Medical / standards
  • Stress, Psychological / etiology
  • Stress, Psychological / psychology
  • Urethra / diagnostic imaging
  • Urinary Bladder / diagnostic imaging
  • Urinary Bladder / physiopathology
  • Urinary Tract Infections / diagnostic imaging*
  • Urinary Tract Infections / etiology
  • Urination
  • Urology / methods
  • Urology / standards
  • Vesico-Ureteral Reflux / complications
  • Vesico-Ureteral Reflux / diagnostic imaging*