Also referred to as VCUG or cystogram, this diagnostic X-ray test helps to determine the bladder capacity and emptying ability and to detect abnormalities of the urethra and the bladder. This test can also detect the narrowing of the urethra secondary to a stricture.
This test is performed in a hospital radiology or urology department or in a health care provider's office by an X-ray technician under a physician's supervision. There is no special preparation required on the patient's prior to the test. The patient will then be asked to lie down on their back and to remain still. A preliminary film of the abdomen and pelvis is a basic part of this examination and this is usually done without a contrast agent (dye). This helps the physician determine the proper radiographic technique and patient positioning. A catheter is inserted into the urethra to the bladder so dye can be injected. As the bladder is filling with this dye, X-rays are taken in various positions and various time intervals. The catheter is then removed and additional X-rays are taken while the patient urinates into a container. Once the bladder is emptied, a final X-ray is taken. The entire test takes approximately one hour.
The patient may experience some discomfort during insertion of the catheter. After the scan, there may be a slight discomfort when urinating for up to 48 hours and the urine may be slightly pink but the patient can resume their daily activities immediately following this test. If discomfort persists, fever develops or urine appears bright red, a physician should be notified.
While a cystourethrogram is considered generally safe, the major risk involves a reaction to the iodine-based dye. Minor reactions include hot flashes, nausea and vomiting. These are usually treated successfully with antihistamines, drugs that reduce the effects of the body's inflammatory compound, histamine. In very rare circumstances, more severe complications - breathing difficulties, low blood pressure, swelling of the mouth or throat and even cardiac arrest - can occur. There may be additional problems such as urinary tract infection.
There is relatively low radiation exposure during this test. However, a patient who is or may be pregnant should notify their physician prior to this examination, as a fetus is susceptible to the risks associated with radiation.