Complications of voiding cystourethrography in the evaluation of infants with prenatally detected hydronephrosis

Purpose: We determined complications in infants undergoing voiding cystoure thrography as part of the evaluation for prenatally detected hydronephrosis . Materials and Methods: We retrospectively reviewed the records of infants r eferred to our institution for the evaluation of prenatal hydronephrosis fr om 1992 to 1997. Infants with a prenatal history of bilateral hydronephrosi s, bladder distention and oligohydramnios, oligohydramnios only or a prenat al abnormality involving any other organ system were excluded from study. O f 206 patients 129 male and 49 female infants underwent postnatal voiding c ystourethrography at our institution. Chart review and a telephone intervie w with the parents were done to assess lower urinary tract infection, pyelo nephritis, hospital admission for urosepsis, gross hematuria, urinary reten tion or skin rash. Results: Postnatal voiding cystourethrography was normal in 138 patients bu t it diagnosed bilateral vesicoureteral reflux in 15, unilateral vesicouret eral reflux in 20, ureterocele in 4 and refluxing megaureter in 1. Of the 1 29 male infants evaluated 101 had undergone circumcision as a newborn, 14 w ere uncircumcised and the circumcision status of 14 was unknown. At voiding cystourethrography suppressive antibiotics were administered to 166 infant s, 7 were not on suppressive antibiotics and antibiotic status was unknown in 5. No patient had a lower urinary tract infection, pyelonephritis or uro sepsis. In addition, there were no episodes of urinary retention, gross hem aturia or skin rash. Conclusions: While the reported rate of new or recurrent infection associat ed with voiding cystourethrography is as high as 6%, we did not identify an y infectious or other complications in infants undergoing voiding cystouret hrography for prenatal hydronephrosis. When properly performed, we believe that voiding cystourethrography is safe and presents little risk in these p atients.