title: Voiding cystourethrogram: How much should we be selective?
abstract: OBJECTIVE
  In this study, we examined the patients' characteristics, who underwent voiding cystourethrography (VCUG), in order to determine any selectivity for indication of this invasive method.
  
  
  METHODS
  After exclusion of indications of neurogenic bladder or antenatal hydronephrosis and control VCUGs, 159 VCUGs performed in our clinic within one year were evaluated. Patients are divided into three groups accoding to age. Clinical characteristic and findings of renal ultrasonography (US) and renal scintigraphy were examined.
  
  
  RESULTS
  Vesicoureteral reflux (VUR) was detected in 61 (38.3%) of 159 patients who underwent cystourethrographic examinations, in 45.8% of the patients with a history of recurrent urinary tract infection (UTI), in 22.0% of the patients with pathological urinary system US without history of recurrent UTI. High-grade reflux rate was significantly more frequent in renal units with pathological US findings. Severe scar was significantly more frequent in renal units with high-grade reflux when compared to renal units without reflux and those with low-grade reflux. Predictive values of recurrent UTI, scarring status and pathological US for VUR were separately analyzed and seen that likelihood of indicating VUR was increased when all 3 risk factors were assessed together.
  
  
  CONCLUSIONS
  Vesicoureteral reflux is a problem in which diagnostic process and management strategy should have to be considered in individualized manner for each patient. Before prescribing invasive VCUG, imaging urinary system by US and scintigraphy and determining whether there is recurrent UTI will improve selectivity and success of VCUG.
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Yel
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Sebahat
authors.initials: S
authors.lastname: Tülpar
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Ruhan
authors.initials: R
authors.lastname: Düşünsel
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Hakan Muammer
authors.initials: HM
authors.lastname: Poyrazoğlu
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: İsmail
authors.initials: İ
authors.lastname: Dursun
authors.affiliation: Department of Nuclear Medicine, Erciyes University School of Medicine Kayseri, Turkey.
authors.forename: Ümmühan
authors.initials: Ü
authors.lastname: Abdülrezzak
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Zübeyde
authors.initials: Z
authors.lastname: Gündüz
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Yılmaz
authors.affiliation: Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Baştuğ
keywords: Children; urinary tract infection; voiding cystourethrography