Urography and voiding cystourethrography: findings in girls with urinary tract infection

Abstract

The voiding cystourethrogram and excretory urogram have been considered essential parts of the evaluation of girls with urinary tract infections. To evaluate the usefulness of these procedures, 523 examinations in girls with urinary tract infections were reviewed retrospectively. The major finding on voiding cystourethrograms was vesicoureteral reflux, occurring in 36% of the children. Of the total group, 8% had excretory urographic evidence of parenchymal scarring. Higher grades of reflux were associated with an increase in parenchymal scarring. All urethras were normal, and only one paraureteral diverticulum was identified. Bladder emptying was incomplete in 46% of the patients. Ovarian radiation doses were measured with "low-dose" and standard systems. On the basis of this study, traditional approaches to the standard workup are questioned.