Nuclear VCUG (Voiding Cysto-Urethrogram)

What is a Nuclear VCUG?

A Nuclear VCUG (Voiding Cysto-Urethrogram) allows us to evaluate your child's urethra and bladder size, shape and capacity. The urethra is the small tube that connects the bladder with the outside of the body.

This procedure can also help us determine whether your child has reflux, a condition where urine from the bladder goes upward back to the kidneys. Your doctor may ask for this exam if your child experiences frequent urinary tract infections.

We do the test by giving your child a radiopharmaceutical through a catheter in the bladder. This "tracer" is medicine combined with a small amount of radioactive material. It travels to the area of your child we need to see and is detected and imaged by a gamma camera.

Radiopharmaceuticals are carefully tested. The risk of side effects is extremely small. Most radiopharmaceuticals used in nuclear medicine studies give less radiation exposure than a day at the beach.

What should you do prior to the exam?

There are no special preparations for your child to follow prior to this exam.
Dress your child comfortably, in clothes that are easily removed. Your child will be given a gown to change into for the procedure.
We have a large variety of video entertainment to choose from. Your child may want to bring a favorite movie to watch during the exam.
You may want to bring a snack or drink for your child to have after the exam.
For female patients, it might be helpful to practice the "frog-legs" or "butterfly" position. The child lies on her back with feet together and knees splayed out to the side.

Note: Parents will be allowed to accompany their child into the exam room. It may be helpful to make other arrangements for siblings.

What should you expect during the exam?

The exam, including preparation, will take on average 30 to 45 minutes depending on how long it takes to fill and empty your child’s bladder.

The technologist will ask why the VCUG is being performed and will explain the procedure to you and your child.
Your child will lay on the x-ray table in a "Frog Position" or "Butterfly Position."
The technologist will wipe down the urethral area with three to four cotton balls soaked in "Brown Soap," which is an iodine based cleaning agent. The soap may feel a bit cool.
A tiny tube, or catheter, will be placed into your child's bladder. Your child may feel some pressure and the sensation or urge to urinate. As a relaxation technique during this process, we will ask your child to take in big deep breaths.
Once the catheter is placed we will secure the tube to your child's leg with a piece or two of tape.
The catheter will be connected to a bottle of saline mixed with a radiopharmaceutical. The saline will flow through the urinary catheter into your child's bladder. Pictures will be taken while the bladder is being filled. Your child will be asked to hold the saline in even though she may feel the urge to urinate.
Once the bladder is full, we will ask your child to urinate while still on the table. (Small children and infants will probably urinate on their own.) We will supply a bedpan or a urinal and may sprinkle cool water on your child to help stimulate urination. Once your child starts to urinate, we will take more pictures.
After your child urinates and the bladder is empty we will remove the catheter.
We may take a few additional pictures to complete the study.
Sedation is not an option for this procedure.

Due to the personal nature of the exam, your child may feel uncomfortable and/or embarrassed. Please assure your child that you will be with her the entire time. The best way to help your child cope with this procedure is to be available for comfort during the test and to speak in simple words that your child can understand.

If you’d like, our child life specialists will help you prepare and support your child during the procedure. We can also arrange to have a child life specialist at your child's appointment to explain the procedure in developmentally appropriate ways and to help your child better cope with the stress of the hospital experience.