What Is a Voiding Cystourethrogram?

A voiding cystourethrogram (VCUG), also known as icturating cystourethrogram (MCU)is a radiological investigation for examination of urinary tract system. The study is used to visualize the urethra, urinary bladder and about the possibility of vesico ureteric reflux (VUR).

When to do voiding cystourethrogram ?

• Recurrent urinary tract infections.
• Urinary tract infection in an infant.
• Suspected bladder outlet obstruction.
• Hydrouretronephrosis on ultrasound.
• Bilateral Hydronephrosis.

The study is conducted under antibiotic cover and in fluoroscopic machine.

Technique

• With all ascepic precautions, bladder is catheterized with a small lumen tube and filled with a liquid called as contrast (as per the normal bladder capacity).
• The sequential video images are taken during filling and voiding phase.
• The images are visualized on the monitor and the and any structural abnormalityies findings are noted.
• The whole procedure takes around 15 to 20 minutes.

Findings

VCUG gives an idea about any abnormality related to bladder size and shape (neurogenic bladder, bladder diverticula, bladder mass etc.). It also identifies urethral problems, such as a blockage along the path of the urine (posterior urethral valve, urethral stricture etc.). VCUG helps in making a diagnosis of vesicoureteric reflux (VUR) in which the urine goes back(reflux) towards kidney. VCUG is the only confirmatory imaging for the diagnosis of vesicoureteric reflux.

What are the risks of voiding cystourethrogram?

There is a mild risk of urinary tract infections so it should always be done under antibiotic cover and also after treating any preexisting urinary tract infections.

There is some risk due to exposure to radiation, however the amount of radiation used in a VCUG is small and is not considered dangerous.