A voiding cystourethrogram (VCUG) exam is a radiology procedure that uses real-time X-ray fluoroscopy to produce images over time of your child’s urinary tract and bladder. By using fluoroscopic technique, your radiologist can see how these organs move and function together, while looking for any abnormalities.
VCUG consists of taking images of the bladder when it’s full and when it’s emptying to check for abnormalities. A contrast dye is introduced into the bladder through a thin, flexible tube inserted into the urethra and bladder while your child lies on their back on a fluoroscopy exam table. The child then empties their bladder while images are taken of the urinary tract during urination, giving the radiologist information about how the organs are functioning. More basic information on fluoroscopy is available in the About Fluoroscopy section.
A voiding cystourethrogram (VCUG) exam is used to:
- Diagnose vesicoureteral reflux, a condition in which the urine flows the wrong way, traveling from the bladder into the kidneys
- Explore reasons for repeated urinary tract infections
- Check to see if treatment for a urinary tract issue was effective
- Check for blockages or abnormalities in the urethra
- VCUG is a safe, and minimally invasive way to evaluate problems with the urinary tract.
- Having a VCUG can mean that your child avoids exploratory surgery.
- The amount of radiation used in a VCUG is unlikely to increase your child’s risk of cancer, and no radiation remains the body after the exam.
- Fluoroscopy uses a low dose of radiation because it uses X-ray technology, but the benefit of an accurate diagnosis far outweighs the risk. Please refer to the About Fluoroscopy section for more information on the risk of radiation used in this exam. Be assured that ARA Children’s Imaging Center has protocols designed keep radiation exposure as low as reasonably achievable while getting an effective diagnostic image.
- If you are pregnant, you will not be able to be with your child while X-rays are taken because of risk to the developing fetus. Please bring a friend or family member to stay with the child.
- A voiding cystourethrogram (VCUG) exam is typically performed in an ARA imaging center and takes about 30 minutes.
- The ARA technologist will prepare you and your child for the exam by explaining the exam and answering questions and concerns.
- Your child will need to change into a gown and remove all jewelry and metal objects.
- Your child will be placed on an exam table that tilts to facilitate the movement of contrast liquid. Our technologists are sensitive about working with the child and will do everything possible to maintain comfort and privacy.
- Wearing sterile gloves, the technologist will clean the genital area. Your child will need to remain still and not touch the area during the exam. Technologists are able to help you distract and redirect the child while performing the exam.
- The technologist will then gently insert a tiny tube (catheter) covered with numbing gel into the urethra (the small opening where urine comes out of the body). The catheter may give your child the feeling that they need to urinate.
- The catheter will be fastened in place with tape and a small urine sample will be taken.
- While there is some discomfort in the placement of the catheter, once it is in place it is usually painless, and your child will not feel anything as the X-rays are taken.
- Contrast dye will begin to fill your child’s bladder. As the contrast liquid moves into the urinary tract, pictures will be taken using the fluoroscope.
- Babies will urinate automatically as the bladder fills, and images will be taken of the process. Older children will be asked to hold their urine until the bladder feels full and then asked to urinate into a urinal or bedpan as the urination process is imaged. The child may need to do this procedure several times.
- Once the catheter is removed, your child can dress and resume normal activities. There may be some discomfort when urinating and possibly a small amount of blood in the urine over the next few days, making it pink. Encourage your child to drink extra fluids.
- You will be able to stay with your child during the exam unless you are pregnant. If you are pregnant, you will not be able to be with your child while X-rays are taken because of risk to the developing fetus. Please bring a friend or family member to stay with the child.
- Your child should wear comfortable, loose-fitting clothing. Please leave all jewelry, piercings, and any other metal objects at home.
- Bring your child’s favorite book or small toy to occupy them during the exam.
- Be sure to tell your technologist about any illness or allergies your child may have.
A radiologist, a physician specifically trained to interpret radiological examinations, will analyze the images and send a signed report to the health care provider who referred you to ARA. Your health care provider will then share the results with you. Your report will also be available on the patient portal within 15 days.