Timing of voiding cystourethrogram in the investigation of urinary tract infections in children

Objective: To determine whether the detection of vesicoureteral reflux I (V UR) in children with a urinary tract infection (UTI) is more likely if the ol I I voiding cystourethrogram (VCUG) is performed early (within the first 7 das after diagnosis) or late (>7 days after diagnosis). Study design: We conducted a retrospective case review of children <5 years of age admitted with a first episode or UTI to a tertiary care pediatric h ospital over a 2-year period. Timing of the VCUG was at the discretion of t he attending pediatrician. Differences in age, sex, mean time to performing the VCUG, and incidence of VUR between the 2 groups (VCUG performed early vs late) were compared by using Student t test (for age) and chi (2) test ( for sex and incidence of VUR). Potential confounders (age and sex) were inc luded in a multiple logistic regression analysis. Results: A total of 162 patients were eligible for inclusion. Mean age was 181 days, and 43.8% were female. The incidence of VUR was 21.6%. The early group consisted of 82 patients, and the late group consisted of 80. No sign ificant difference was found for age or sex or for the incidence of reflux (17.1% vs 26.3%, P = .219), with a crude odds ratio of .59 (95% Cl 0.3-1.2, P > .05). Conclusion: The rate of detection of VU R in children with a First episode of UTI does not Increase when the VCUG is done early (within the first 7 da ys of diagnosis) rather than later.