A voiding cystourethrogram (VCUG) is a special type of x-ray called a fluoroscopy to study the bladder and urethra. Contrast medium is injected through a catheter that is inserted through the urethra into the bladder. Once the bladder is filled the radiologist will remove the catheter. X-ray images will be taken while the bladder is full and as you empty it to look for any problems with the bladder and urethra. The function of the kidneys is to produce urine and move it through the ureters into the bladder. When the bladder is full, a mechanism prevents urine from flowing back into the kidneys and instead moving it through the urethra. The backflow of urine is called the vesicoureteral (VU) reflux. It occurs due to problems with the valves or ureters. If mild, urine flows back to the lower ureters; if severe, urine can travel back to the kidneys and case them to swell. In some children this problem may be congenital.
In children, a voiding cystourethrogram (VCUG) is usually done to diagnose the cause of urinary tract infections, such as due to the flow of urine back into the ureters from the bladder. Voiding cystourethrogram (VCUG) can also be used to diagnose other issues, such as obstruction of the urinary tract before it enters the bladder, urination abnormalities due to high pressure in the bladder, inability to empty the bladder, and urinary tract infections. The vesicoureteral reflux is the cause of urinary tract infection in as many as 40% of newborns and 25% of older children. Patient with suspected urethra and bladder abnormality.
-A VCUG provides adequate information for diagnosis and treatment without harming the kidneys. -Avoids surgery and other invasive tests.
-The voiding cystourethrogram (VCUG) cannot detect obstruction of the ureters and additional testing may be required if the doctor suspects that may be a problem.
The bladder is filled with contrast medium using an infant feeding tube under aseptic precautions; a Foley catheter can be used for older children intermittent screening of the patient on fluoroscopy, while distending the bladder with contrast, is necessary to check for a ureterocele or VUR after the bladder is filled to its capacity (which will vary as per age of patient) the patient is now asked to void
You should inform your physician of any medications your child is taking and if he or she has any allergies, especially to contrast materials. Also inform your doctor about recent illnesses or other medical conditions. Your child does not need to fast or wear special clothing. Explain to your child what will happen during the examination so that there will be no confusion about what is expected. Your child will have to remove all clothing and wear a gown. Sedation is rarely needed for this procedure
The doctor will let you know when your child may get dressed and you may leave. If you have an appointment with another doctor in the hospital afterward, the radiologist will give you a note with the results to take with you.Your child may experience some discomfort, pink urine, or feel a bit of stinging while going to the bathroom. This is normal and will go away. Giving him / her extra fluids will help.
Radiation is a risk for this procedure. However, the amount of radiation for this procedure will be limited to only what is absolutely necessary. The amount of radiation used is usually small and lead sheets will be used to protect other parts of the body from radiation. For children between 5 and 10 years old, the radiation used is approximately 1.6 millisievert (mSv), which is the same amount received from the environment over a period of 6 months. For younger children, the radiation amount is 0.8 millisievert (mSv), which is the amount of radiation received from the environment over a period of 3 months.
What risks will my child be exposed to during this procedure?
Your child will be exposed to ionizing radiation (x-rays) during this procedure. While all attempt to minimize exposure to x-rays will be practiced, the benefits of an accurate diagnosis outweighs the exposure that occurs during the exam. Because children are more sensitive to radiation exposure than adults, the technician will adjust the equipment and procedures to deliver the lowest possible dose to young patients.