Hello all, The general protocol in my office for UTIs: If first time UTI in any child < 5 yo, VCUG and U/S after treatment along with post treatment culture. If no VUR, then we follow up every 3 months with a culture for 1-2 years. (overkill?) If female > 5 yr, with nonfebrile UTI, just f/u cultures as above. Boys any age with UTI have VCUG , U/S and f/u cultures. SIBLINGS: How about if/to what extent to work- up siblings of those found to have VUR? For a twin, we will order a VSUG and U/S. How about other siblings? Depends on age and gender? Carolyn Angioli, RN, MS, PNP Fairfax, VA.