Invasive testing, such as voiding cystourethrogram, retrograde urethrogram, and cystourethroscopy have been discouraged because they have been ineffective in locating sources of the bleeding.

B = voiding cystogram of the same patient (three months after surgery), showing a smooth-funneled bladder neck of excellent caliber; a decrease in trabeculation is present.

Renal ultrasound is not an appropriate substitute for voiding cystourethrogram in screening for vesicoureteral reflux in siblings; screening might not be necessary in older children at all ...