Voiding Cystourethrogram (VCUG)

What is a voiding cystourethrogram (VCUG)?

A VCUG (Voiding Cysto-Urethrogram) uses x-rays and a contrasting agent to evaluate your child's urethra and bladder size, shape, and capacity. This procedure uses x-rays and a contrasting agent that is administered by catheter into your child’s bladder. A VCUG 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.

What is fluoroscopy?

A VCUG is a fluoroscopy procedure. This is an imaging technique that uses x-rays to create "real-time" or moving images of the body. It helps doctors see how an organ or body system functions. A radiologist (x-ray doctor) and radiologic technologist perform the procedures together.

In most of these types of exams, your child will lie on the table while the x-ray machine, called a fluoro tower, is brought overhead. The fluoro tower has a curtain on it; it's like being in a tent or a small car wash! You, the doctor and your child will be able to see the images on a television monitor in the room.

What should you do prior to the exam?

There are no special preparations for your child to follow prior to the exam.

If your child has a noted allergy to radiographic contrast, certain preparations may be necessary.

Dress your child comfortably, in clothes that are easily removed. Your child will be given a gown to change into for the procedure.

Note: Parents will be allowed to accompany their child into the exam room. Other arrangements should be made for siblings.

Women who are pregnant or may be pregnant will be asked to leave the exam room during the procedure. Please make sure that there is someone else available to accompany your child during the exam, if needed.

What should you expect during the exam?

This exam, including preparation, takes an average of 20 to 30 minutes.

The technologist will ask why the VCUG is being performed and will explain the procedure to you and your child.
Your child’s bladder will need to be catheterized for this exam. Your child will lay on the x-ray table with her legs 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, and one cotton ball soaked in water. The soap may feel a bit cool.
A tiny feeding 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 "blow out birthday candles," or 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 iodinated contrast material that will be visualized on the x-ray screen. The contrast material will flow through the urinary catheter into your child's bladder.
The radiologist will pull the x-ray machine, called the “fluoro tower,” over your child and take several x-rays. Your child will be asked to roll side to side periodically, and told to hold the contrast in even though she may feel the urge to urinate.
Once the bladder is full, the radiologist will ask your child to urinate while still on the table. (Small children and infants will probably urinate on their own.) We may supply a bedpan or a urinal, and/or sprinkle warm water on your child to help stimulate urination. Once your child starts to urinate, more x-rays will be taken. While your child is urinating, the catheter will slide out without your child feeling any discomfort. A few additional x-rays will be obtained to complete the study.

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.

If you’d like, our child life specialists will help you prepare your child and support her 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.

Radiation Safety for Fluoroscopic Procedures

We are careful to limit the dose of radiation your child receives. Your child will wear a lead shield during the procedure. We also adjust the dose of radiation according to the size of the child and we administer the x-rays in a pulsed, rather than constant fashion to minimize the amount of radiation.