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Contrast and Radionuclide Cystography

Contrast cystography uses X-rays and contrast agents (dyes) to assess the bladder for rupture, vesicoureteral reflux, or demonstrate a vesical fistula. Vesicoureteral reflux, is defined as urine backflow caused by an obstruction or congenital defect. During past decades, urologists have added a nuclear version of this test, called a radionuclide cystogram, to their arsenal, particularly to study reflux (see radionuclide cystogram). Many physicians believe this technology is a better surveillance tool for tracing the migration of urine through the urinary tract because it uses less radiation exposure (some estimates suggest up to 200 times) than the conventional cystogram. It also does not rely on fluoroscopy, a radiological technique for visually examining the bladder, which contributes to the higher radiation exposures.

The doctor will insert a catheter through the patient's urethra and into the bladder. The dye or radioactive agent is then injected through the catheter into the bladder. Images are taken at various stages of filling, from various angles, to visualize the bladder. Additional images are taken after drainage of the dye (see voiding cystourethrography). In surveying for vesicoureteral reflux, the urologist employs the same steps, using the radio-pharmaceutical, to collect continuous images every 10 to 15 seconds. While conventional voiding cystograms are still necessary to evaluate the male urethra for posterior valves and bladder trauma, the majority of reflux studies today are done effectively with radionuclide cystography.

While the risks are low, patients may experience urinary tract infections from the catheter. The incidence of reaction to the contrast dye or radioactive agent is rare, since the agents are administered directly into the urinary system and not into the blood stream.



Reviewed January 2011

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Contrast and Radionuclide Cystography Glossary
  • bladder: The bladder is a thick muscular balloon-shaped pouch in which urine is stored before being discharged through the urethra.

  • catheter: A thin tube that is inserted through the urethra into the bladder to allow urine to drain or for performance of a procedure or test, such as insertion of a substance during a bladder X-ray.

  • congenital: Present at birth.

  • cyst: An abnormal sac containing gas, fluid or a semisolid material. Cysts may form in kidneys or other parts of the body.

  • cystogram: An X-ray examination of the bladder utilizing contrast material injected into the bladder.

  • fistula: An abnormal opening between two organs (between the bladder and vagina in women or the bladder and the rectum in men).

  • fluoroscopy: Imaging technique that takes a real time "movie" of the body.

  • infection: A condition resulting from the presence of bacteria or other microorganisms.

  • ions: Electrically charged atoms.

  • obstruction: something that obstructs, blocks, or closes up with an obstacle

  • posterior: Situated at the rear or behind something.

  • radiation: Also referred to as radiotherapy. X-rays or radioactive substances used in treatment of cancer.

  • radioactive: Relating to or making use of radioactive substances or the radiation they emit.

  • radiologic: X-ray.

  • radionuclide: Radioactive nuclide.

  • radionuclide cystogram: A test using a radioactive material that is placed in the bladder to evaluate the structure of the bladder and processes inside.

  • reflux: Backward flow of urine. Also referred to as vesicoureteral reflux (VUR). An abnormal condition in which urine backs up from the bladder into the ureters and occasionally into the kidneys, raising the risk of infection.

  • reflux: Backward flow.

  • stage: Classification of the progress of a disease.

  • ureter: One of two tubes that carry urine from the kidneys to the bladder.

  • ureteral: Pertaining to the ureter. Also referred to as ureteric.

  • urethra: A tube that carries urine from the bladder to the outside of the body. In males, the urethra serves as the channel through which semen is ejaculated and it extends from the bladder to the tip of the penis. In females, the urethra is much shorter than in males.

  • urethrography: X-ray examination of the urethra involving radiopaque fluid used to detect any narrowing or other abnormalities.

  • urinary: Relating to urine.

  • urinary tract: The system that takes wastes from the blood and carries them out of the body in the form of urine. Passageway from the kidneys to the ureters, bladder and urethra.

  • urinary tract infection: Also referred to as UTI. An illness caused by harmful bacteria, viruses or yeast growing in the urinary tract.

  • urine: Liquid waste product filtered from the blood by the kidneys, stored in the bladder and expelled from the body through the urethra by the act of urinating (voiding). About 96 percent of which is water and the rest waste products.

  • urologist: A doctor who specializes in diseases of the male and female urinary systems and the male reproductive system. Click here to learn more about urologists. (Download the free Acrobat reader.)

  • urology: Branch of medicine concerned with the urinary tract in males and females and with the genital tract and reproductive system of males.

  • vesicoureteral reflux: Also referred to as VUR. An abnormal condition in which urine backs up from the bladder into the ureters and occasionally into the kidneys, raising the risk of infection.

  • void: To urinate, empty the bladder.

  • voiding: Urinating.

  • voiding cystogram: Also referred to as VCUG or voiding cystourethrogram. A specific X-ray that examines the urinary tract. A catheter (hollows tube) is placed in the urethra (tube that drains urine from the bladder to the outside of the body)and the bladder is filled with a liquid dye. X-ray images are taken as the bladder fills and empties. The X-rays will show if there is any reverse flow of urine into the ureters and kidneys.

  • voiding cystourethrography: Also referred to as voiding cystourethrogram or voiding cystogram. A catheter is placed in the urethra and the bladder is filled with a contrast dye. X-ray images are taken as the bladder fills and empties to show any blockage or reverse urine flow.

Contrast and Radionuclide Cystography Anatomical Drawings

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