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Urinary and Genital Disorders (Children)

When is additional testing necessary?



My daughter is four years old and is being treated with Bactrim for a second UTI after complaints of burning with urination. Her first one was two months ago with pronounced symptoms such as frequency, urgency, incontinence and burning with urination. Neither were accompanied with fever. Her pediatrician recommended an evaluation with a pediatric urologist. I am concerned that the he will routinely order a VCUG which can be very invasive, traumatic and painful. What are the appropriate guidelines in regards to age and UTI`s for further testing? Would a renal ultrasound be sufficient for preliminary evaluations or is a renal u/s and vcug routinely performed?


A VCUG is necessary to look for reflux, a condition that often can lead to kidney infections. If a child has a normal ultrasound and has other risk factors for infections, such as constipation or incontinence, a VCUG may not strictly be needed. Most children with infections do not have reflux.

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Response by:

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