Background: A child's ability to void during voiding cystourethrograms (VCUG) is important in diagnosing vesicoureteral reflux (VUR). At our institution the majority of VCUG studies are performed under sedation. The potential effect sedation has on the child's ability to void may impair our ability to detect VUR. We evaluated all VCUG studies performed over a two year period to assess the impact of sedation on VUR.
Methods: Retrospective evaluation was performed on all patients undergoing VCUG studies at our institution from 2002 to 2004. Patient characteristics, presenting symptoms, bladder capacity, emptying ability, and diagnoses were recorded. Children were categorized as receiving sedation versus not receiving sedation. All sedated children received propofol deep sedation. Statistical analyses were performed using the Pearson chi-square test.
Results: 335 patients were reviewed, of which 73.8% were female. Urinary tract infections (50.7%) and previous VUR (25.7%) were the most common factors necessitating a VCUG study. Other factors included a family history of reflux (1.5%) and hydronephrosis on prenatal ultrasound (6.0%). Sedation was administered in 195 patients and 52.3% were able to void to completion. Of the patients that did not reeive sedation, 67.9% were able to void to completion (p=0.004).
Conclusions: Children that underwent a VCUG study with sedation were less likely to void to completion. By performing VCUG under sedation, we may not be able to accurately detect VUR in children. Large prospective studies are needed to better assess bladder emptying and sedation when performing VCUG studies.

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