To screen or not to screen—the role of vcug in infant uti

Access through your institution Buy or subscribe New research has found that, for infants presenting with their first febrile UTI, renal and bladder ultrasonography (RBUS) has low positive

predictive value for abnormalities determined by voiding cystourethrogram (VCUG), confirming previous results and questioning the current diagnostic framework. In 2011, the American Academy

of Pediatrics (AAP) updated their guidelines for the treatment of children aged 2–24 months with a first febrile UTI, to recommend that RBUS be used to identify genitourinary anomalies, with

VCUG only to confirm suspected abnormalities indicative of vesicoureteral reflux (VUR), or on recurrence of UTI. Previously, screening combined both procedures. The rationale behind this

change is that VCUG represents overtreatment in the first instance, as the incidence of high-grade VUR is low in this population overall, but much higher in those with recurrent UTI. With

watchful waiting until recurrence, the discomfort and potentially harmful radiation burden of VCUG can be restricted to those infants most likely to have high-grade VUR. This is a preview of

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ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Nelson, C. P. _ et al_. Ultrasound as a screening test

for genitourinary anomalies in children with UTI. _Pediatrics_ 10.1542/peds.2013-2109 Download references Authors * Robert Phillips View author publications You can also search for this

author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Phillips, R. To screen or not to screen—the role of VCUG in infant UTI.

_Nat Rev Urol_ 11, 185 (2014). https://doi.org/10.1038/nrurol.2014.45 Download citation * Published: 25 February 2014 * Issue Date: April 2014 * DOI: https://doi.org/10.1038/nrurol.2014.45

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