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Urinary and Genital Disorders (Children)

Is it necessary to have a VCUG after one UTI?

09/18/2007

Question:

My daughter is 3 and in the middle of toilet training. last week she was diagnosed with her first UTI. She is currently on a 10 day dose of Bactrum and the doctor wants her to have 12 weeks of low dose antibiotics and an ultra-sound and VCUG. Of course I want what is best for her, but given the circumstances, I think it might be best to wait and see if she has a second UTI before putting her through the VCUG? She didn`t have any symptoms other than it hurt when she urinated one time. She is also very independent and often snuck in to used the potty without me knowing and I suspect she sometimes wiped the wrong way before I could catch her. Her Doctor said the lab results show the bacteria is the type that often comes from wiping back to front. Whew! Anyway, if it is within my right to refuse the VCUG at this point and opt until she has a send UTI, I would like to but am not sure if I can. Thanks for your time!

Answer:

My current recommendation is not to do any studies if the UTI was not associated with fever or abdominal or back pain. If there was a fever, however, then a VCUG and renal US are advisable.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University