5 Studies Linking Pediatric VCUGs to Child Sexual Abuse (CSA)

Safe. Low-risk. Painless.

These are usually words that parents hear after their child is referred for a voiding cystourethrogram (VCUG) procedure, the “gold standard” test for diagnosing vesicoureteral reflux (VUR) in pediatric patients. Given that hundreds of thousands of children undergo VCUGs every year, it’s painful to imagine how many parents were unable to give true informed consent for their child’s care.

The truth is that the VCUG procedure has been repeatedly proven to result in similar trauma to child sexual abuse (CSA). In fact, young VCUG patients were used as proxies in CSA studies as early as 1990. However, this is never disclosed to parents.

Legally effective informed consent isn’t just a recommended guideline; it’s an ethical and moral obligation for practicing physicians in the U.S. The doctrine holds doctors accountable for disclosing all reasonable information to parents of pediatric patients regarding a proposed medical treatment or procedure, an essential part of respecting caregivers’ right to make informed medical decisions for their children.

In this blog, we discuss the similarities between VCUGs and CSA.

What Research Says About Pedatric VCUGs & Child Sex Abuse (CSA)

The VCUG is a routine diagnostic test performed on hundreds of thousands of children every year. Despite a wealth of objective evidence establishing its high rate of similarity to child sexual abuse, this critical information is withheld from parents, robbing children of the care they need and deserve to recovere from the "psychological equivalent" of a "violent rape." We must do better to fully inform and educate families before VCUG to help children avoid lasting harm.

While hospitals and providers continue to market VCUGs as safe, painless, and minimally invasive in 2025, the existing research paints a very different picture. Below are some of the studies linking pediatric VCUGs to child sex abuse:

#1. Goodman et al., 1990

Researchers used the VCUG procedure to study children’s memory of trauma, likening it to sexual abuse incidents.

#2. Merritt et al., 1994

VCUG was used as a comparative traumatic event, alongside actual CSA, to examine children’s memory for distressing events.

#3. Pipe et al., 1997

Builds on prior VCUG trauma research, reinforcing its comparison to CSA in memory studies.

#4. Pezdek et al., 2004

According to researchers, the VCUG procedure “was used as the target event in this study because it is similar in many ways to child sexual abuse, the real-world behavior that we hope to generalize these results to.”

#5. Azarfar et al., 2014

Examined psychological effects post-procedure; notably compared VCUG trauma to a “violent rape.”

Similarities Between Pediatric VCUGs & CSA

• Sexual contact

• Contact forced against the child’s will

• Removal of clothing

• The child is anxious

• The child is encouraged to relax and not resist

• The incident is not voluntary

• The incident is conducted by trusted authority figures, which often extends to the caregiver who permitted it to occur

Note: We never aim to discredit or invalidate those who have experienced child sexual abuse. In the case of VCUG patients, child sexual abuse (CSA) is an objectively traumatic experience that is subjectively perceived by patients as sexually traumatic.

Are VCUG Providers Violating the Informed Consent Doctrine?

As a parent, you want to make the best medical decisions for your child's health—but you can't do that without being fully informed.

This is where the informed consent doctrine comes in. Providers are legally obligated to obtain legally effective informed consent from guardians prior to administering pediatric care to children.

To fulfill their obligations under the law, physicians must disclose all pertinent information related to the proposed care. For VCUG and any other medical procedure, this rule extends to any reasonable information that might affect the family's decisions for their child's medical treatment.

At a minimum, this means that pediatric providers should be disclosing:

• The condition being treated.

• The nature and character of the proposed medical care.

• The expected results of the proposed treatment.

• Recognized forms of alternative treatments that may also be available, including non-treatment.

• Recognized serious risks, complications, and anticipated benefits.

Join the Unsilenced Movement

For decades, doctors have not disclosed the risks and long-term harm of VCUG to parents. The Unsilenced Movement is here to take back the narrative and hold medical professionals accountable for fulfilling their obligations under the informed consent doctrine.

Join the Unsilenced Movement to help us raise awareness about the real and life-altering health impacts of VCUG trauma. Because kids deserve better. #MoreThanATest