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Urinary and Genital Disorders (Children)

Does may daughter need a VCUG?

03/29/2001

Question:

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

Answer:

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.

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Response by:

Rama   Jayanthi, MD Rama Jayanthi, MD
Clinical Assistant Professor of Urology
College of Medicine
The Ohio State University