, Volume 42, Issue 3, p 284
Date: 30 Dec 2011

VCUG and the question of sedation

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For a condition as common as urinary tract infection (UTI), it is surprising how much controversy persists regarding its optimal imaging evaluation. Multiple studies have been performed over the years, with recommendations generally divided into “top down” and “bottom up” approaches, depending upon whether the emphasis is on upper tract disease (pyelonephritis) or lower tract abnormalities (vesicoureteral reflux [VUR]). While there is still dissent, recent European studies and an American Academy of Pediatrics position paper show a shift to emphasize evaluation of the upper urinary tract, with decreased emphasis on the diagnosis of VUR.

Regardless, the radiological investigation of VUR will continue to have some role in UTI evaluation. Whether one performs a fluoroscopic voiding cystourethrogram (VCUG), a nuclear medicine cystogram or a contrast-enhanced cystosonogram, catheterization of the bladder is required, and this creates anxiety in parents and patients. Part of pediatric radiolo

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