Too Many Cystograms in the Investigation of Urinary Tract Infection in Children?

Authors

  • P. M. CAVANAGH,

    Corresponding author
    1. Department of Radiology, Addenbrooke's Hospital, Cambridge, and University of Cambridge
    Search for more papers by this author
    • 2

      MA, MB, MRCP, Senior Registrar, Department of Radiology. Addenbrooke's Hospital.

  • T. SHERWOOD

    1. Department of Radiology, Addenbrooke's Hospital, Cambridge, and University of Cambridge
    Search for more papers by this author
    • 3

      MA, MB, FRCP, FRCR, Professor of Radiology, University of Cambridge.


X-ray Department, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ.

Abstract

Summary— We report on 62 children referred for a first micturating cystourethrogram (MCU) and intravenous urogram (IVU) because of suspected or proven urinary tract infection (UTI). The study represents 1 year's experience of a district hospital, but excludes children below the age of 6 months and those with a diagnosis of urinary drainage anomaly. The IVU proved a good predictor of gross vesicoureteric reflux, which affected 11 children, all with suspect IVUs. Lesser grades of reflux can occur in the presence of a normal IVU but are unlikely to damage the kidney. They can be managed by treating symptoms of infection rather than by the need to protect nephrons. In our study a suspect IVU implied a 79% chance of gross reflux, and a normal IVU excluded such reflux. It is suggested that children over 6 months of age with a clinically important infection should be spared an MCU unless the IVU is abnormal, or troublesome infections recur.

Ancillary