In urology, voiding cystourethrography (VCUG) is a technique for visualizing a person's urethra and urinary bladder while the person urinates (voids). The technique consists of catheterizing the person in order to fill the bladder with a radiocontrast agent, typically diatrizoic acid. Under fluoroscopy (real time x-rays) the radiologist watches the contrast enter the bladder and looks at the anatomy of the patient. If the contrast moves into the ureters and back into the kidneys, the radiologist makes the diagnosis of vesicoureteral reflux, and gives the degree of severity a score. The exam ends when the person voids while the radiologist is watching under fluoroscopy. Consumption of fluid promotes excretion of contrast media after the procedure. It is important to watch the contrast during voiding, because this is when the bladder has the most pressure, and it is most likely this is when reflux will occur.
Vesicoureteral reflux (kidney reflux) is diagnosed with an ultrasound and VCUG. Children who have recurrent urinary tract infections are given this test to determine the risk of subsequent infections causing potentially damaging kidney infections.
- All males with recurrent UTIs (urinary tract infections) or abnormality on ultrasound if first UTI.
- Females < 3 years of age with their first UTI.
- Females < 5 years of age with febrile UTIs
- Older females with pyelonephritis or recurrent UTIs
- Suspected obstruction (e.g. bilateral hydronephrosis)
- Suspected bladder trauma or rupture
- Stress incontinence (urine)
- Vesico ureteric reflux
- Untreated urinary tract infection
- Hypersensitivity to contrast media
- Fever within the past 24 hours
"Although the side effects of VCUG are not common, they are important. These complications that can occur in both sexes include UTI, hematuria, cystitis as well as urinary dysfunction following a catheterization, phobia of urination, nocturia, and stopping urination. In the literature, psychological trauma resulting from VCUG was considered the same as from a violent rape, especially in girls."
- "Cystocele (Prolapsed Bladder) | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 2017-12-17.
- Azarfar A, Esmaeeili M, Farrokh A, Alamdaran A, Keykhosravi A, Neamatshahi M, Hebrani A, Ravanshad Y (May 2014). "Oral midazolam for voiding dysfunction in children undergoing voiding cystourethrography: a controlled randomized clinical trial". Nephro-Urology Monthly. 6 (3): e17168. doi:10.5812/numonthly.17168. PMC 4090665. PMID 25032141.