{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:45:46Z","timestamp":1792608346609,"version":"4.5.0"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,11,1]]},"abstract":"<jats:p>The voiding cystourethrogram (VCUG) is a frequently performed test to diagnose a variety of urologic conditions, such as vesicoureteral reflux. The test results determine whether continued observation or an interventional procedure is indicated. VCUGs are ordered by many specialists and primary care providers, including pediatricians, family practitioners, nephrologists, hospitalists, emergency department physicians, and urologists. Current protocols for performing and interpreting a VCUG are based on the International Reflux Study in 1985. However, more recent information provided by many national and international institutions suggests a need to refine those recommendations. The lead author of the 1985 study, R.L. Lebowitz, agreed to and participated in the current protocol. In addition, a recent survey directed to the chairpersons of pediatric radiology of 65 children\u2019s hospitals throughout the United States and Canada showed that VCUG protocols vary substantially. Recent guidelines from the American Academy of Pediatrics (AAP) recommend a VCUG for children between 2 and 24 months of age with urinary tract infections but did not specify how this test should be performed. To improve patient safety and to standardize the data obtained when a VCUG is performed, the AAP Section on Radiology and the AAP Section on Urology initiated the current VCUG protocol to create a consensus on how to perform this test.<\/jats:p>","DOI":"10.1542\/peds.2016-2590","type":"journal-article","created":{"date-parts":[[2016,10,31]],"date-time":"2016-10-31T09:07:26Z","timestamp":1477904846000},"source":"Crossref","is-referenced-by-count":61,"title":["Establishing a Standard Protocol for the Voiding Cystourethrography"],"prefix":"10.1542","volume":"138","author":[{"given":"Dominic","family":"Frimberger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Gisela","family":"Mercado-Deane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SECTION ON UROLOGY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SECTION ON RADIOLOGY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick H.","family":"McKenna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Christopher","family":"Austin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"Austin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul P.","family":"Greenfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.D. Anthony","family":"Herndon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas F.","family":"Kolon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"MacNeily","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian H.","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Gisela","family":"Mercado-Deane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Annam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Bulas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Cassese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Milla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Glen","family":"Seidel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Cassady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2016,11,1]]},"reference":[{"issue":"2","key":"2021120921175722100_B1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/BF02388714","article-title":"International system of radiographic grading of vesicoureteric reflux.","volume":"15","author":"Lebowitz","year":"1985","journal-title":"Pediatr Radiol"},{"issue":"4","key":"2021120921175722100_B2","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1016\/j.juro.2011.04.006","article-title":"Voiding cystourethrogram\u2014are our protocols the same?","volume":"186","author":"Palmer","year":"2011","journal-title":"J Urol"},{"issue":"3","key":"2021120921175722100_B3","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1542\/peds.2011-1330","article-title":"Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.","volume":"128","author":"Roberts","year":"2011","journal-title":"Pediatrics"},{"issue":"3","key":"2021120921175722100_B4","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1148\/radiol.2492062066","article-title":"Pediatric radiation exposure and effective dose reduction during voiding cystourethrography.","volume":"249","author":"Ward","year":"2008","journal-title":"Radiology"},{"key":"2021120921175722100_B5","year":"2012"},{"key":"2021120921175722100_B6","unstructured":"Alliance for Pediatric Radiation in Imaging. Image Gently. Available at: www.imagegently.org. Accessed January 25, 2016"},{"key":"2021120921175722100_B7","author":"Palmer","year":"2011"},{"issue":"4","key":"2021120921175722100_B8","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.juro.2014.10.002","article-title":"Bladder volume at onset of vesicoureteral reflux is an independent risk factor for breakthrough febrile urinary tract infection.","volume":"193","author":"Alexander","year":"2015","journal-title":"J Urol"},{"issue":"3","key":"2021120921175722100_B9","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1007\/s003300101108","article-title":"Cyclic voiding cystourethrography: is vesicoureteral reflux missed with standard voiding cystourethrography?","volume":"12","author":"Papadopoulou","year":"2002","journal-title":"Eur Radiol"},{"issue":"1","key":"2021120921175722100_B10","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s004670050010","article-title":"Cyclic voiding cystourethrography in the diagnosis of occult vesicoureteric reflux.","volume":"14","author":"Polito","year":"2000","journal-title":"Pediatr Nephrol"},{"issue":"4 pt 2","key":"2021120921175722100_B11","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1016\/S0022-5347(06)00619-7","article-title":"Bladder volume at onset of reflux on initial cystogram predicts spontaneous resolution.","volume":"176","author":"McMillan","year":"2006","journal-title":"J Urol"},{"issue":"4","key":"2021120921175722100_B12","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s00247-003-0874-0","article-title":"Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study.","volume":"33","author":"Stokland","year":"2003","journal-title":"Pediatr Radiol"},{"issue":"5","key":"2021120921175722100_B13","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1093\/jpepsy\/jsj081","article-title":"Brief report: optimizing children\u2019s memory and management of an invasive medical procedure: the influence of procedural narration and distraction.","volume":"31","author":"Salmon","year":"2006","journal-title":"J Pediatr Psychol"},{"key":"2021120921175722100_B14","unstructured":"American College of Radiology; Society for Pediatric Radiology. ACR\u2013SPR Practice Parameter for the Performance of Voiding Cystourethrography in Children. Reston, VA: American College of Radiology and the Society for Pediatric Radiology; revised 2014 (Resolution 13). Available at: www.acr.org\/\u223c\/media\/ACR\/Documents\/PGTS\/guidelines\/Voiding_Cystourethrography.pdf. Accessed January 25, 2016"},{"issue":"25","key":"2021120921175722100_B15","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1056\/NEJMoa1401811","article-title":"Antimicrobial prophylaxis for children with vesicoureteral reflux.","volume":"370","author":"Hoberman","year":"2014","journal-title":"N Engl J Med"},{"issue":"1","key":"2021120921175722100_B16","doi-asserted-by":"crossref","first-page":"e20161212","DOI":"10.1542\/peds.2016-1212","article-title":"Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures: update 2016.","volume":"138","author":"Cot\u00e9","year":"2016","journal-title":"Pediatrics"},{"issue":"2 pt 1","key":"2021120921175722100_B17","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1097\/01.ju.0000068720.10881.b3","article-title":"Effectiveness of lidocaine lubricant for discomfort during pediatric urethral catheterization.","volume":"170","author":"Gerard","year":"2003","journal-title":"J Urol"},{"issue":"1","key":"2021120921175722100_B18","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/0022-3468(91)90426-T","article-title":"Bladder capacity in infants.","volume":"26","author":"Fairhurst","year":"1991","journal-title":"J Pediatr Surg"},{"key":"2021120921175722100_B19","first-page":"20","article-title":"Urodynamics in normal infants and children.","volume":"114","author":"Hj\u00e4lm\u00e5s","year":"1988","journal-title":"Scand J Urol Nephrol Suppl"},{"issue":"4 pt 2","key":"2021120921175722100_B20","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1097\/01.ju.0000083638.36182.5e","article-title":"Bladder pressure at the onset of vesicoureteral reflux determined by nuclear cystometrogram.","volume":"170","author":"Cooper","year":"2003","journal-title":"J Urol"},{"issue":"4","key":"2021120921175722100_B21","doi-asserted-by":"crossref","first-page":"807","DOI":"10.2214\/ajr.153.4.807","article-title":"Reliability of voiding cystourethrography to detect reflux.","volume":"153","author":"Jequier","year":"1989","journal-title":"AJR Am J Roentgenol"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2016-2590\/1062006\/peds_20162590.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2016-2590\/1062006\/peds_20162590.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T05:57:25Z","timestamp":1639115845000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/138\/5\/e20162590\/60509\/Establishing-a-Standard-Protocol-for-the-Voiding"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,1]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,11,1]]},"published-print":{"date-parts":[[2016,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2016-2590","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,1]]},"article-number":"e20162590"}}