Original Article   

Minerva Pediatrics 2022 Jul 04

DOI: 10.23736/S2724-5276.22.06824-0

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

A comparison of patient and parental experiences and diagnostic quality of suprapubic versus transurethral voiding cystourethrogram in children

Maximilian P. BRANDT ¹, Julia GOLLER ¹, Gundula STAATZ ², Allegra GROßMANN ¹, Nikita FISCHER ¹, Axel HAFERKAMP ¹, Raimund STEIN ³, Annette SCHRÖDER ¹ ✉

¹ Department of Urology and Pediatric Urology, Mainz University Medical Center, Mainz, Germany; ² Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology, Mainz University Medical Center, Mainz, Germany; ³ Department of Pediatric, Adolescent and Reconstructive Urology, Medical Faculty Mannheim, University of Medical Center Mannheim, Heidelberg University, Mannheim, Germany

INTRODUCTION: Voiding cystourethrogram (VCUG) used in the radiologic evaluation of the upper and lower urinary tract can be performed by suprapubic puncture (SP) or by transurethral catheterization (TC). Data on which instillation technique is superior are scarce. VCUG tends to be a distressing procedure for both parents and children.
METHODS: We evaluated the experience of VCUG analyzing 417 families with focus on contrast medium instillation in groups of single and repeated VCUGs and assessed quality and complication rate. The median age of children who had undergone VCUG was 38.6 months (0 - 159 months). Satisfaction with informed consent (IC), degree of fear and pain in parents and children prior and during VCUG were recorded. VCUG was compared to blood withdrawal and vaccination.
RESULTS: Satisfaction with IC was higher for repeated VCUG (p= 0.024) which resulted in a lower degree of fear in parents and children. The fear of children during VCUG was lower when SP was performed rather than TC. This was in contrast to parental fear of SP (all p< 0.05). In repeated VCUGs, children who underwent SP were less afraid. Better diagnostic quality was more commonly reported with SP, yet the complication rate was higher (p=0.035).
CONCLUSIONS: Our study highlights the importance of IC as a pivotal necessity before VCUG is conducted. SP might be beneficial over TC in terms of fear and distress in the case of repeated VCUGs. Diagnostic quality is comparable, both methods are safe and complications are low.

KEY WORDS: VCUG; Voiding Cystourethrogram; Suprapubic catheterization; Transurethral catheterization; Complications