Voiding Cystourethrogram (VCUG)

Overview

What is a voiding cystourethrogram (VCUG)?

A voiding cystourethrogram, or VCUG, is a study used to look at bladder and urethral abnormalities and to determine if you have ureteral reflux. Ureteral reflux means urine in the bladder is flowing back into the ureters (the tubes leading from the kidneys to the bladder). This can result in kidney infections.

Trauma or urethral infections can lead to urethral strictures (areas of narrowing), which may cause difficulty in emptying the bladder (peeing).

The most common reasons to perform a voiding cystourethrogram are:

  • Persistent urinary tract infections.
  • To evaluate reflux after certain medical procedures.
  • Your family history of reflux.
  • Prior urethral trauma, infections or surgery.

Test Details

What happens before a voiding cystourethrogram (VCUG)?

Before the procedure the provider places a Foley catheter into the bladder through the urethra (the passage where urine flows out of your body). People with urethral stricture or obstruction may have had a suprapubic catheter (SPC) placed to drain the bladder. This catheter is inserted directly into the bladder through the skin. In these cases the VCUG is done using the SPC and a urethral catheter isn’t needed.

If a child is having the test, a parent or guardian may be present. If your child is getting a VCUG, it’s a good idea to talk with your child before entering the department to explain exactly what will happen to ease their anxiety.

What happens during a voiding cystourethrogram (VCUG)?

  1. You’ll lie flat on a radiography table. A bottle of contrast material and tubing are attached to the catheter after it’s placed. The contrast material is used to fill your bladder to its maximum capacity. Your age and weight are considered to determine the amount of contrast material that will be used.
  2. Your bladder is visualized using a fluoroscope (camera) as it fills. After it fills the catheter is removed and you’ll be asked to urinate. You may be asked to stand during urination.
  3. You’ll be given a bedpan or urinal because imaging continues during urination to image the urethra and to assess for reflux. Pictures need to be obtained during both filling and voiding phases because reflux can occur at either stage.
  4. The test takes approximately 30-45 minutes.

What happens after a voiding cystourethrogram (VCUG)?

After the procedure, a radiologist interprets the images, writes a report, and delivers the results to your doctor. Then your doctor will confer with you about treatment for you or your family member.

Last reviewed by a Cleveland Clinic medical professional on 09/25/2020.

References

  • RadiologyInfo.org. Children’s (Pediatric) Voiding Cystourethrogram (https://www.radiologyinfo.org/en/info.cfm?pg=voidcysto) Accessed 10/28/2020.
  • Urology Care Foundation. What is a Voiding Cystourethrogram? (http://www.urologyhealth.org/urologic-conditions/voiding-cystourethrogram) Accessed 10/28/2020.
  • Merck Manuals. Urinary Reflux. (https://www.merckmanuals.com/home/children-s-health-issues/birth-defects-of-the-urinary-tract-and-genitals/urinary-reflux?query=Vesicoureteral%20Reflux%20(VUR%29) Accessed 10/28/2020.

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