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


METHODS
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 chi(2) 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).


CONCLUSIONS
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.
Mahant
S
S
Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
To
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Friedman
J
J
D000367:Age Factors; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014554:Urination / Q000502:physiology*; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000503:physiopathology*