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Tuesday, March 11, 2014
Does My Daughter Need a VCUG Test?
My 22 mos. old daughter recently was diagnosed with a confirmed UTI, apparently caused by the E-coli bacteria. A one week dose of anti-biotic immediatly took care of it w/ a clean urine sample after the medication was done. She also had an ultrasound on her bladder & kidneys, which came back normal. We are now being told she needs the VCUG test because she`s under age 5 w/ a confirmed UTI. At the time of her infection, her only real symptom was foul smelling urine, she had no fever or other symptoms. This is her first UTI & the VCUG test looks so invasive, is it necessary at this point or should we wait till she has another confirmed UTI?
This issue is controversial. Urinary tract infections include bladder infections and kidney infections. A child with a kidney infection typically has a high fever and abdominal or flank pain. In contrast, a bladder infection is characterized by foul-smelling urine, suprapubic pain, loss of urinary control (if they are toilet trained), and burning with urination. Kidney infections are more serious, because they can cause kidney damage or scarring., particularly with repeated infections. Urinary reflux increases the risk of developing a kidney infection, and this condition is diagnosed mainly with a VCUG. Although many recommend obtaining a VCUG after the first UTI, I only recommend it if the child has had signs of a kidney infection. Consequently, in your daughter's case, I would not obtain it right now, but if she has a kidney infection, I would definitely get a VCUG.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University