Cystourethrography | Health and Life

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Cystourethrography

Cystourethrogram is an X-ray test that takes pictures of your bladder and urethra while you are urinating. A thin flexible tube (catheter) is inserted through your urethra into your bladder.

A liquid material that shows up well on an X-ray picture (contrast material) is injected into your bladder through the catheter, then X-rays are taken with the contrast material in your bladder. Additional X-rays may be taken while urine flows out of your bladder, in which case the test is called a voiding cystourethrogram (VCUG).

If X-rays are taken while contrast material is being injected into the urethra, the test is called retrograde urethrogram because the contrast material flows into the bladder opposite the usual direction of urine flow.

Why It Is Done

Cystourethrogram is done to:

Determine the cause of repeated urinary tract infections.
Investigate suspected injuries to the bladder or urethra.
Determine the cause of urinary incontinence.
Detect structural problems of the bladder and urethra.
Investigate in men a suspected enlargement (hypertrophy) of the prostate or narrowing (stricture) of the urethra.
Detect urinary reflux. See an illustration of abnormal backflow of urine.
Evaluate abnormalities first detected by intravenous pyelography.

How To Prepare

Tell your doctor if:

You are or might be pregnant.
You have symptoms of a urinary tract infection.
You are allergic to the iodine dye used in the contrast material or any other substance that contains iodine. Also tell your doctor if you have asthma, are allergic to any medications, or have ever had a serious allergic reaction (anaphylaxis) from any substance (such as the venom from a bee sting or from eating shellfish).
Within the past 4 days, you have had an X-ray test using barium contrast material (such as a barium enema) or have taken a medication (such as Pepto-Bismol) that contains bismuth. Barium and bismuth can interfere with test results.
You have an intrauterine device (IUD) in place.
You do not need to restrict your food or fluid intake before this test. You may be asked to sign a consent form authorizing this procedure. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will indicate . Complete the medical test information form to help you understand the importance of the test.

If you are breast-feeding, give your baby formula for 1 to 2 days after the procedure until the contrast material has passed from your urinary system.

How It Is Done

Cystourethrogram is done by a urologist or a radiologist. The doctor may be assisted by an X-ray technologist. The test can be done on an outpatient basis without being admitted to the hospital.

You will need to take off all or most of your clothes, and you will be given a cloth or paper covering to use during the test. You will be asked to urinate just before the test begins.

You will be asked to lie on your back on an X-ray table. Your genital area will be cleaned and draped with sterile towels. Men may be given a lead shield that covers their genitals to protect them from radiation. However, women's ovaries cannot be shielded without blocking the view of the bladder. The doctor will insert a well-lubricated catheter through your urethra and into your bladder and will then slowly inject the contrast material through the catheter until your bladder is full. You will be asked to assume various positions while X-rays are taken.

The catheter is then removed and you will be asked to lie down on the table and to urinate into a bedpan. While the contrast material flows out, additional X-rays will be taken. Fluoroscopy may be used continuously during the procedure to view the flow of contrast material. You may be asked to stop urinating, assume a different position, and begin urinating again. If you are unable to urinate lying down, you may be asked to do so standing up.

After the test is over, drink lots of fluids to help wash the contrast material out of your bladder and to reduce any burning on urination.

This test usually takes 30 to 45 minutes.

How It Feels

You may feel a slight burning when the catheter is inserted. You will have a feeling of fullness in your bladder and an urge to urinate when the contrast material is injected. You may feel embarrassed at having to urinate with others present, but you needn't be because this procedure is quite routine for the X-ray staff. If you find yourself feeling embarrassed, take deep, slow breaths and try to relax.

During and after the test you may feel a burning sensation when you urinate, which is caused by irritation of your urethra from the catheter. After the procedure, you may need to urinate frequently for several days. You may also notice some burning during and after urination. Drink lots of fluids to help minimize the burning and to help prevent a urinary tract infection.

Risks

Complications from cystourethrogram are rare. Occasionally this test may lead to a urinary tract infection. If the contrast material is injected with too much pressure, there is some chance of damage to the bladder or urethra.

There is always some concern about the effects of exposure to any radiation, including the low level radiation used in this test. If this test is really necessary, the radiation risk is generally very low compared with the potential benefits of the test.
Some people may have an allergic reaction to the contrast material.

After the procedure,It is normal for your urine to have a pinkish tinge for 1 to 2 days after the test. Contact your doctor immediately if you have:

Blood in your urine after 2 days.
Lower abdominal pain.

Signs of a urinary tract infection. These signs include:

Pain or burning upon urination.
An urge to urinate frequently, but usually passing only small quantities of urine.
Dribbling (inability to control urine release).
Urine that is reddish or pinkish, foul-smelling, or cloudy.
Pain in the back just below the rib cage on one side of the body (flank pain).
Fever and chills.
Nausea and vomiting.

Results

Cystourethrogram is an X-ray test that takes pictures of your bladder and urethra while you are urinating. Preliminary results may be available immediately after the cystourethrogram. Final results are usually available within 1 to 2 days.

Normal:

The bladder appears normal. There is no abnormal backward flow (reflux) or leakage of the contrast material from the bladder. The contrast material flows evenly out of the bladder through a smooth-walled urethra.

Abnormal:

Abnormal findings may include bladder stones, tumors, narrowing or pouches in the wall (diverticula) of the urethra or bladder, an enlarged prostate, abnormal backward flow (reflux) of urine up into the ureters, or an inability to completely empty the bladder. If the test was done because of possible injury to the bladder, a tear may be found in the bladder wall or urethra.

What Affects the Test

Factors that can interfere with your test and the accuracy of the results include:

Barium (from a previous barium enema test), gas, or stool (feces) in the intestinal tract.
Embarrassment at having to urinate in front of other people that may make it difficult for you to urinate on command. This may make it difficult to perform the test.
Pain during urination as a result of inserting the catheter into the urethra. This may cause an interrupted or less vigorous urinary stream, muscle spasm, or incomplete relaxation of the sphincter muscles that control the bladder.
Cystourethrogram is not usually done during pregnancy because the X-rays could damage the developing fetus.

2011-07-20