Voiding Cystourethrogram—Are Our Protocols the Same?

Palmer, Blake; Ramji, Faridali; Snyder, Charles T.; Hemphill, Michael; Kropp, Bradley P.; Frimberger, Dominic

doi:10.1016/j.juro.2011.04.006

Cited by 22 publications

(11 citation statements)

References 7 publications

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“…Recent studies have demonstrated significant variability among institutions with no standardized VCUG protocols, as well as lack of consistent reporting practices. 25,26 In addition to potential child and parental distress, VCUGs also expose the patient to radiation, albeit at low doses. 27 While benefits generally outweigh the risks, it is logical to maximize the quality of data obtained from a single VCUG by collaboration with our radiology colleagues to generate complete reports.…”

Section: A N U S C R I P Tmentioning

confidence: 99%

Vesicoureteral Reflux Index: 2-Institution Analysis and Validation

et al. 2016

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Section: A N U S C R I P Tmentioning

confidence: 99%

Vesicoureteral Reflux Index: 2-Institution Analysis and Validation

et al. 2016

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“…Across North America, most VCUG protocols are identical: parents’ presence, contrast infusion by gravity, thin catheter without balloons, no contrast dilution and voiding without a catheter in place. Differences among institutions were the height of contrast medium and when to stop filling contrast medium . However, no significant differences in the VUR detection rate between two different heights of 50 cm or 100 cm were reported .…”

Section: Practical Guide For Carrying Out Vcugmentioning

confidence: 92%

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

et al. 2018

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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.

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“…Voiding cystourethrography has unique ability to provide detailed information about both the anatomical and functional status of the urinary tract. However, the literature has shown significant variability among institutions regarding the VCUG protocol used, as well as inconsistent reporting of the findings from the VCUG between institutions . Although VUR grade is routinely reported, other crucial anatomical and functional findings are consistently underreported.…”

Section: How To Perform a Vcugmentioning

confidence: 99%

New trends in voiding cystourethrography and vesicoureteral reflux: Who, when and how?

Arlen

Cooper

2019

Int J of Urology

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Vesicoureteral reflux, retrograde flow of urine from the bladder into the upper urinary tract, is one of the most common urological diagnoses in the pediatric population. Diagnosis and subsequent management of urinary reflux have become increasingly debated in the past decade, with divergent opinions over which patients should be evaluated for reflux, and when detected, which children should receive intervention. Although some argue that vesicoureteral reflux is a “phenotype” that often resolves without intervention, others contest that untreated reflux has the potential to cause irreversible renal damage over time. Voiding cystourethrogram images the urethra and bladder during both bladder filling and emptying, as well as the ureters and kidneys when reflux is present, and is considered the gold standard for diagnosing vesicoureteral reflux. Once detected, therapeutic options for urinary reflux are diverse, ranging from observation with or without low‐dose antibiotic prophylaxis to a variety of operative interventions. Management should be based on a multitude of factors including patient age, risk of subsequent urinary tract infections, risk of renal parenchymal injury, a given child's projected clinical course and parental preference. Over the past two decades, investigators have elucidated many crucial voiding cystourethrogram findings in addition to grade that provide significant prognostic information and are useful in determining the best course of action for a child on a more individualized basis.

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Voiding Cystourethrogram—Are Our Protocols the Same?

Cited by 22 publications

References 7 publications

Vesicoureteral Reflux Index: 2-Institution Analysis and Validation

Vesicoureteral Reflux Index: 2-Institution Analysis and Validation

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

New trends in voiding cystourethrography and vesicoureteral reflux: Who, when and how?

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