The diagnostic value, parental and patient acceptability of micturating cysto-urethrography in children

Objectives: To evaluate the medical indications and outcome including psych ological and physical consequences of micturating cysto urethrography. Methods: A prospective study of 165 consecutive children undergoing MCUG du ring a 3 month period. Medical data, including outcome was recorded. The di stress of the child was recorded by the radiographer at the time of the exa minations. Postal questionnaires were sent to parents one week after the te st to obtain information on their own and their child's perception of the t est, and any physical and/or behavioural changes. Results: Age distribution for first and subsequent MCUG. [GRAPHICS] 73% of first MCUG's were requested because of urinary tract infection. 52% of first MCUG's in infants were abnormal compared with 13% in older childre n aged 1 to 4 years. 29 children aged 4 and over underwent a second or subs equent MCUG (53% abnormal). These children would be suitable for indirect c ystography. One quarter of children experienced difficulty in passing urine following the test, haematuria was experienced by four. Radiographers reco rded severe distress in 27% of children and 27% of parents also recorded di stress. Conclusions: A high incidence of distress was detected for both parent and child. Units should establish special guidelines for the use of this invasi ve procedure. A clear explanation of the investigation to parents and child ren should be standard practice. Routine employment of sedation for patient s may be advisable. Alternative methods of imaging should he considered and evaluated, and indirect isotope cystography employed where appropriate.