VCUG

Voiding Cystourethrography (VCUG) is a medical imaging procedure used to examine the bladder and urethra while the bladder fills and empties. The primary purpose of a VCUG is to identify abnormalities in the lower urinary tract, detect the presence of vesicoureteral reflux (VUR), and assess the urethra's function, particularly in children with recurrent urinary tract infections or in individuals who have experienced trauma to the pelvic region.

Procedure

During a VCUG, a radiopaque contrast agent is introduced into the bladder through a catheter inserted into the urethra. As the bladder fills, X-ray images are taken to visualize the bladder's shape and size and to check for VUR, which occurs when urine flows backward from the bladder towards the kidneys. This condition can lead to recurrent urinary tract infections and kidney damage if left untreated. After the bladder is filled, the patient is asked to void while additional X-rays are taken to assess the urethra's structure and function during urination.

Indications

VCUG is primarily indicated for:

• Diagnosing and grading vesicoureteral reflux.
• Evaluating recurrent urinary tract infections, especially in children.
• Assessing the lower urinary tract's anatomy and function after pelvic surgery or trauma.
• Investigating urinary incontinence.
• Evaluating complex congenital urinary tract abnormalities.

Risks and Complications

While VCUG is generally safe, it does involve exposure to ionizing radiation, making the risk-benefit ratio an important consideration, especially in children. Other potential risks include:

• Allergic reaction to the contrast material.
• Urinary tract infection from the catheter.
• Discomfort or pain during the catheter insertion.

Interpretation of Results

A radiologist typically interprets the VCUG images. Normal results would show a normal bladder shape and size during filling and no evidence of vesicoureteral reflux during voiding. Abnormal results may indicate the presence of VUR, urethral obstruction, bladder diverticula, or other abnormalities affecting the lower urinary tract.

Conclusion

VCUG is a valuable diagnostic tool in evaluating the lower urinary tract's anatomy and function. It plays a crucial role in diagnosing vesicoureteral reflux and other urinary tract abnormalities. Despite its benefits, the risks associated with radiation exposure and the invasive nature of the procedure necessitate careful consideration before its use, particularly in pediatric populations.