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Voiding Cystourethrogram (VCUG)

More Information About Voiding Cystourethrogram (VCUG)


In a cystogram procedure, your bladder is examined using X-rays and a contrast agent—fluid that allows a clearer X-ray image to be made. By showing the bladder’s position and shape, a cystogram can help to diagnose certain conditions. Cystograms are often used to diagnose reflux, which can cause recurrent urinary tract infections. They are also valuable in detecting polyps or tumors in the bladder, and to ensure that the bladder has not ruptured after a pelvic trauma.

Preparing for the Examination
Before your examination, the radiographer will explain the procedure to you and answer any questions you might have. If you are a woman of childbearing age, the radiographer will ask the date of your last menstrual period and if there is any possibility that you are pregnant. Next, the radiographer will ask if you have any allergies. It is important to list all allergies to food and medicine, and to let the radiographer know if you have a history of hay fever or asthma.
Having the Examination
Here’s an outline of what happens during the exam:
  • You’ll put on a hospital gown and the radiographer will show you to the bathroom so that you can empty your bladder.
  • Next you’ll be positioned on your back on the X-ray table, with your knees flexed. Your perineal (pubic) area will be washed, and then the radiographer or a radiology nurse will gently insert a catheter into your urethra (the tube extending from your bladder that urine passes through when you urinate).
  • Next, a radiologist or a urologist will slowly fill your urinary bladder with the contrast agent. The fluid will create a feeling of pressure and fullness, as if you need to urinate.
  • After your bladder is full, the physician will take radiographs using fluoroscopy. A fluoroscope is an X-ray unit attached to a television screen that allows real-time viewing.
  • After this, the catheter will be removed and you will be able to use the bathroom to empty your bladder. The contrast agent that you expel is a clear, odorless substance and will not be visible to you.
  • After you return to the X-ray room, an additional radiograph will be taken. This final radiograph will show whether any contrast agent is left in your bladder. If there is, it will be expelled the next time you urinate.
The Voiding Cystourethrogram
Voiding cystourethrograms follow the same routine as the basic cystogram with one difference. Toward the end of the examination, when the urinary catheter is removed, you will be asked to urinate into a special urinal that X-rays can pass through. Radiographs will be taken while you urinate to show the size and shape of the bladder during urination. This exam is most commonly used for young girls with a history of recurrent bladder infections.
Will My Child be Sedated During the Procedure?
Nurse Administered Nitrous Oxide (NANO) in commonly used for sedation for the VCUG procedure.  It is safe and efficient reducing the turnaround time for recovery from 30 minutes down to 5.  The patients remain fully awake and cooperative while maintaining the amnesia affect - up to 80% of children are unable to recall a painful or traumatic procedure.  While it is not used for all patients in all situations, it is an option for reducing distress during the procedure.
After the Examination
A radiologist will review the images taken during the exam, and your personal physician will be given a report of the findings.

Questions or Concerns
If you have any questions or concerns, please call the Radiology Department at 253-403-1578.