Voiding Cystourethrogram (VCUG) | Boston Children's Hospital (2024)

How do I prepare my child for the VCUG?

We suggest talking to your child about why the test is important and what it is designed to accomplish. Explain that you will be with your child the entire time. If you are pregnant, you will not be able to be in the room when x-rays are taken. Please bring another family member or friend instead.

There are no restrictions on eating or drinking before the exam. If you have questions about the test or how to help your child prepare, you may call Child Life specialist Angela Franceschi at 617-355-6923 before you come to the hospital.

What happens before the VCUG?

In a survey of our patients, parents compared the discomfort of a VCUG as similar to or better than an immunization (Sandy N et al. Assessment of parental satisfaction in children undergoing voiding cystourethrogram without sedation. J Urol 2011; 185 (2):658:662).

The test is performed in the morning. On the day of the VCUG, you will speak with a radiologist, who will explain what will happen during the procedure and answer any questions or concerns you may have. A Child Life specialist or another clinical staff member will also be present to assist you in caring for your child during the test.

When you arrive in the Radiology Department:

  • You will check in.
  • You will be greeted by a staff member who will ask you some questions about your child's condition, explain the test, and answer your questions.
  • Your child will change into a hospital gown.
  • If your child is toilet-trained, he will be asked to go to the bathroom before the exam.
  • You and your child will be taken to the procedure room.

What happens during the test?

  • The technologist will help your child onto the fluoroscopy table.
  • Your child will need to remove underpants and socks.
  • Your child will need to lie on his or her back. Girls will position their legs like a frog's. Our VCUG team is very aware of the sensitive nature of the area to be tested and makes every effort to ensure privacy and comfort.
  • The technologist will put on clean gloves and wash between your child's legs with soap and water on cotton balls. It will be important for your child to remain still and to avoid touching his body below the waist. We realize laying still may be challenging for your child. We will give you suggestions on ways to distract your child in order to help them keep his body still.
  • The radiologist will then gently slide a very small tube (a catheter) coated with numbing gel into the small opening where urine comes out of the body (the urethra). The catheter can sometimes make children feel as though they need to urinate.
  • The tube will be taped in place and a urine sample will be collected.
  • A radio-opaque liquid will flow from a bottle through a tube, and into the catheter to fill your child's bladder. This contrast material illuminates the urinary tract on x-ray images.
  • Using fluoroscopy, a special x-ray technique, the radiologist will obtain images of your child's bladder filling and emptying. You will be able to see this on a monitor in the room.
  • If your child is old enough, we will ask him or her to urinate right on the table into a towel or a cup. This may be difficult, but it's important. Babies will urinate on his own when the bladder is full.

What happens after the VCUG?

The technologist will let you know when your child may get dressed and you may leave. If you have an appointment with another doctor in the hospital afterward, the radiologist will give you a note with the results to take with you. The radiologist will then prepare a written report for your child's doctor.

Your child may have some discomfort, pink urine, or feel a bit of stinging while going to the bathroom. This is normal and will go away. Drinking extra fluids will help.

Call your child's doctor if your child has red blood in the urine, pain, or a fever.

Are there risks associated with VCUG?

Your child will be exposed to ionizing radiation (x-rays) during this procedure. While we always attempt to minimize exposure to x-rays, we believe that the benefit of an accurate diagnosis outweighs the exposure that occurs during the exam.

Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.

Voiding Cystourethrogram (VCUG) | Boston Children's Hospital (2024)

FAQs

What is a VCUG procedure for a child? ›

A VCUG, or a voiding cystourethrogram, is a minimally invasive test that uses a special x-ray technology called fluoroscopy to visualize your child's urinary tract and bladder. A VCUG can help: diagnose vesicoureteral reflux, a condition in which urine flows the wrong way, from the bladder back up to the kidneys.

What is the difference between a cystourethrogram and a VCUG? ›

A VCUG takes place in an exam room with an X-ray machine, a long table and a television screen. We often explain to patients that the X-ray machine is a large camera for taking pictures inside the body. A cystogram is exactly the same procedure, except that the patient will not urinate (void) at the end of the exam.

What age is voiding cystourethrogram for? ›

Recent guidelines from the American Academy of Pediatrics (AAP) recommend a VCUG for children between 2 and 24 months of age with urinary tract infections but did not specify how this test should be performed.

Are babies sedated for VCUG? ›

Some children over 1 year old may get sedation for the test. If your child has sedation, they must not eat or drink before the test. Talk to your doctor about whether sedation is needed. Otherwise, a VCUG doesn't need any other special preparation.

What is a VCUG procedure for a girl? ›

Your child will be asked to urinate into towels while she is lying down. The catheter will come out while she urinates. It is important that she stays still while she urinates, since X-rays will be taken. The radiologist will check the X-rays to make sure they are complete before you leave.

How painful is a VCUG? ›

How painful is a VCUG? It's normal to feel some discomfort during a VCUG, especially when your provider inserts the catheter. Your bladder may also feel uncomfortably full and you may feel like you want to or need to pee. Some people feel anxious and nervous about a VCUG.

How is a voiding cystourethrogram done? ›

As the bladder fills, x-rays are taken in different positions and times. The catheter is taken out and more x-rays are taken while you pass urine into a container. Once your bladder is empty, a final x-ray is taken. The entire test takes about an hour.

Why are VCUGS traumatic? ›

Ellen Lonnquist, a family and trauma therapist at Womencare Counseling, said that given the young age of most VCUG patients and the perceived sexual nature of the examination, it's possible that patients repress memories until events in adulthood trigger them.

How long does a VCUG test take? ›

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.

What is the alternative to VCUG? ›

ceVUS uses ultrasound, the same kind used to image a fetus in the womb, along with a special contrast dye that makes the ultrasound images clearer. Unlike VCUG, there's no radiation, the ultrasound probe is small and unintimidating, and caregivers can hold their child during the entire screening.

When is a VCUG necessary? ›

For infants and children >2 months of age and not toilet trained, a vcug is recommended after a second febrile UTI occurs or if a abnormality is detected on renal us after the first febrile UTI.

What are the complications of voiding cystourethrogram? ›

Another possible and more serious complication following a VCUG is a urinary tract infection (UTI). This should be minimized by using aseptic technique during the catheterization. Other complications, such as bladder perforation and anaphylactic reaction to the contrast agent are fortunately rare.

What is a VCUG test for children? ›

A pediatric voiding cystourethrogram (VCUG) uses fluoroscopy – a form of real-time x-ray – to examine a child's urinary bladder and lower urinary tract. Exam results allow your physician to determine whether your child's condition requires no therapy, medication, or surgery.

What is a common pathologic indication for a pediatric VCUG? ›

As per American College of Radiology (ACR) and Society for Pediatric Radiology (SPR) guidelines clinical indications for voiding cystourethrography include, but are not limited to: urinary tract infection. dysuria. dysfunctional voiding. hydronephrosis and/or hydroureter.

How much does a VCUG cost? ›

Procedure Details

On MDsave, the cost of a Cystogram (VCUG) ranges from $326 to $845.

What are the side effects of the VCUG? ›

You may need to urinate more often for several days after the test. You may also notice some burning during and after urination. This usually goes away after 1 or 2 days. Your urine may look pink for several days.

What is a child life specialist in VCUG? ›

Child Life Specialists

These professionals offer positive coping strategies using medical play, developmentally appropriate language, and safe exploration of medical equipment to help the child relax during an exam.

References

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