Purpose or Case Report: Fluoroscopic voiding cystourethrograms (VCUG) play a crucial role in pediatric radiology, enabling real-time visualization of the lower genitourinary tract. This educational exhibit summarizes the clinical indications, technique, clinically significant findings, and potential complications associated with VCUG, aiming to provide a strong foundational review for radiologists-in-training.

The lower genitourinary tract, comprising the ureters, bladder and urethra, is implicated in various pediatric pathologies that can lead to long-term morbidity if left undiagnosed or untreated. VCUG is a dynamic study, allowing for visualization of the lower genitourinary tract bladder and urethra during filling and voiding, making it an invaluable tool in pediatric radiology for detection of both functional and structural pathologies.

In this presentation we will review the most common indications for VCUG in the pediatric population as well as use a case-based approach to the discuss the following pathologies associated with the lower genitourinary tract and related conditions of surgical interest.

●Vesicoureteral reflux and its grading
●Congenital Abnormalities
-Posterior Urethral Valves
-Diverticula
-Anorectal malformations
-Prune belly syndrome
-Duplicated renal collecting system
-Congenital Megaureter
●Trauma
-Urethral disruption
-Urethral stricture
-Bladder injury/disruption
●Post-operative evaluation
-Ureteral reimplantation

We will also discuss tips and tricks for the performance of the pediatric VCUG. Additionally, in the face of complications, prompt recognition and intervention remain crucial. We will review commonly encountered challenges faced by the performing radiologist.

Fluoroscopic VCUG remains an invaluable diagnostic tool in pediatric radiology. For radiologists-in-training, mastering the technique, understanding clinical indications, and being able to interpret findings accurately are essential. With patient-centered care and adherence to best practices, VCUG can provide vital insights into pediatric lower urinary tract pathologies.
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