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Wednesday, November 26, 2014
Urinary and Genital Disorders (Children)
Does may daughter need a VCUG?
My 7-year-old daughter recently had a UTI and kidney infection. It was her first. Her doctor has asked that she undergo a VCUG. My husband doesn`t feel it is necessary to put her through this test because she has only had one UTI/kidney infection that should have been diagnosed several months ago by her pediatrician when we took her to see him because of incontinence. I disagree and feel that possible kidney damage is too severe a risk to wait and see if she has another infection. Some of the literature that I have read indicates a VCUG only after recurrent UTIs in female patients. What is your opinion on this matter. Thank you for your assistance and advice
This is a very complicated question and one that will get different responses from different individuals. Not all 7 year old girls require a VCUG after a first UTI. However if the child was ill with the infection (high fever, lethargy, etc) or if there were many febrile illnesses as a younger child that might have been unrecognized UTI`s then a VCUG is required. At a minimum your daughter should have an US to make sure the kidneys are normal. If a 7 year old had a `bladder infection` meaning symptoms such as burning, frequency or mild abdominal pain and has a normal US then I would argue that a VCUG may not be absolutely necessary. However it must be stated that one cannot always differentiate a kidney from a bladder infection on symptoms and many physicians would suggest a VCUG after a single infection. Younger children, less than 4 years of age, should have a VCUG after a single UTI. Lastly if your daughter had incontinence earlier in the year she may not have been infected at the time.
Rama Jayanthi, MD
Clinical Assistant Professor of Urology
College of Medicine
The Ohio State University