Voiding Cystourethrogram (VCUG): Procedure & Results (2024)

How is a VCUG performed?

The test involves a healthcare provider inserting a urinary catheter (a long, flexible tube) into your urethra and up into your bladder. Then, they push an iodine-based contrast dye through the catheter and into your bladder. The radiologist will take X-rays of the fluid inside your bladder to see what it looks like when it’s full. The catheter is then removed and they’ll then take X-rays of your bladder emptying to see where the contrast fluid goes.

How long does a VCUG test take?

The test takes about 30 to 45 minutes.

Does VCUG require sedation?

Sedation is rarely necessary for a VCUG. Some children may need sedation, though. If your child’s provider thinks sedation is a good idea based on your child’s medical history, they’ll talk to you about how to prepare for sedation.

How do I prepare for a VCUG?

Let your healthcare provider know about any medications you take and any allergies you have. They may ask that you stop taking certain medications in the days prior to a VCUG test. If you (or your child) may be pregnant, let your healthcare provider know.

It’s normal to feel some anxiety leading up to the test, especially since you’ll be awake. Let your healthcare provider know you’re feeling worried. They may be able to help ease your worries.

A parent or guardian is typically allowed to stay with their child if the child is the one getting a VCUG. Most healthcare providers recommend preparing your child before the procedure. Explaining exactly what will happen and that you’ll be with them the whole time are good ways to ease their anxiety. Answer their questions and provide clear and honest answers. Your child’s pediatrician may be able to help you determine how to best prepare them for the test. For young children, bringing a comfort item is recommended.

Since there’s no sedation, restricting food or beverages before the test isn’t necessary.

What happens during a VCUG?

A VCUG test generally follows these steps for both adults and children:

1. Disrobe your lower body. You’ll remove your lower garments (such as pants or skirts) and undergarments. Your healthcare provider may give you a gown or sheet for cover.
2. Lie down on a table on your back. People with penises will lay with straight legs. People with vagin*s will lay in a frog or butterfly position (knees open and soles of the feet touching). This allows healthcare providers to have the best access to your urethra.
3. A healthcare provider will wash your genital area with mild soap and water. They may put a special numbing gel on your urethra.
4. A healthcare provider inserts a tiny, soft tube called a catheter into your bladder through your urethra (the hole you pee out of). This can feel uncomfortable or cause minor discomfort (an unpleasant feeling that’s less intense than pain), but it shouldn’t cause any pain. The tube connected to the catheter is taped to your thigh.
5. The X-ray machine will move so it’s directly over your pelvic region. It won’t touch you.
6. Your provider inserts a liquid through the catheter to fill your bladder. This liquid contains a contrast material that’ll clearly highlight your urinary tract on the X-ray image. It helps radiologists see how liquid flows in and out of your bladder.
7. The radiologist takes X-rays to capture what your bladder looks like when it’s filling up.
8. You may feel the urge to pee while your bladder is filling. It’s important not to pee until your bladder’s full and your provider tells you that you can pee. It may be difficult to prevent infants and young children from peeing.
9. Once your bladder is full, the catheter will be removed and a radiologist will tell you that you can pee.
10. For children, healthcare providers may allow them to pee into a cup, in a bedpan or directly onto the table (which has been covered in towels). As they do this, the radiologist will continue to take X-rays of their bladder emptying.
11. If you’re an adult, your provider will ask you to pee in a bedpan or urinal once your bladder is full. A radiologist will continue to take X-rays as you completely empty your bladder.

It’s important to note that X-rays are taken both while your bladder is filling and while it’s emptying because reflux can happen at both stages. Your radiologist is there to help guide the process, so listen to their instructions while they conduct the test. If you’re accompanying your child, try to provide extra comfort to them during the filling and emptying steps. Letting them hold your hands or a comfort object may help, as well as distracting them with a positive, happy voice.

What should I expect after a VCUG?

You can go home right after a VCUG and return to your normal activities. You may feel a stinging or burning sensation when you pee for the next 24 to 48 hours. Drink lots of fluids and use the bathroom as soon as you feel the urge. This can prevent a urinary tract infection (UTI). It’s also normal to pee more often in the days following a VCUG. Your pee may be pink, but it should never be red.

If any of these symptoms last longer than 48 hours or if your pee is red, contact your healthcare provider.

What are the benefits of a VCUG?

The benefit of a VCUG is that it allows your provider to see how liquid flows through your urinary tract. It helps them diagnose conditions that, if left alone, could lead to kidney damage.

What are the risks of a VCUG?

A VCUG is a safe procedure, but there are minor risks. Some people can have a reaction to the dye if it goes into their bloodstream and not their bladder. But this is rare.

Your healthcare provider minimizes your exposure to radiation by placing a special blanket over you, but you’ll still have a tiny amount of radiation exposure. The benefit of an accurate diagnosis typically outweighs this risk. Pregnant people should let their healthcare provider know they’re pregnant before the test.

Some minor side effects of VCUG include:

• Hot flashes.
• Nausea or vomiting.
• A burning sensation when you pee (for about 24 to 48 hours).
• A UTI from your provider placing the catheter (this is rare).

Serious side effects could include:

• Difficulty breathing.
• Low blood pressure.
• Swelling of your throat or mouth.

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. This is also normal. Try to take long, deep breaths. It may help to bring a stress ball to squeeze or a picture of a loved one so that you can soothe or calm yourself.

A VCUG can be stressful for a child. Try to make every attempt to comfort them while also explaining to them that the test is necessary to help them. Ask your healthcare provider for specific tips if you’re unsure of how to handle the situation.