The diagnostic value, parental and patient acceptability of micturating cysto-urethrography in children.
OBJECTIVE
To evaluate the medical indications and outcome including psychological and physical consequences of micturating cysto urethrography.


METHODS
A prospective study of 165 consecutive children undergoing MCUG during a 3 month period. Medical data, including outcome was recorded. The distress of the child was recorded by the radiographer at the time of the examinations. Postal questionnaires were sent to parents one week after the test to obtain information on their own and their child's perception of the test, and any physical and/or behavioural changes.


RESULTS
Age distribution for first and subsequent MCUG. [table: see text] 73% of first MCUG's were requested because of urinary tract infection. 52% of first MCUG's in infants were abnormal compared with 13% in older children aged 1 to 4 years. 29 children aged 4 and over underwent a second or subsequent MCUG (53% abnormal). These children would be suitable for indirect cystography. One quarter of children experienced difficulty in passing urine following the test, haematuria was experienced by four. Radiographers recorded severe distress in 27% of children and 27% of parents also recorded distress.


CONCLUSIONS
A high incidence of distress was detected for both parent and child. Units should establish special guidelines for the use of this invasive procedure. A clear explanation of the investigation to parents and children should be standard practice. Routine employment of sedation for patients may be advisable. Alternative methods of imaging should be considered and evaluated, and indirect isotope cystography employed where appropriate.
Robinson
M
M
Royal Belfast Hospital for Sick Children, Belfast.
Savage
J
J
Stewart
M
M
Sweeney
L
L
D001007:Anxiety / Q000209:etiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology; D011446:Prospective Studies; D002666:Psychology, Child; D011795:Surveys and Questionnaires; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014554:Urination; D014567:Urography / Q000009:adverse effects / Q000523:psychology*