Voiding cystourethrogram

In urology, a voiding cystourethrogram (VCUG), also micturating cystourethrogram (MCUG), is a test used to visualize the urethra and urinary bladder that takes place during micturition (voiding). The test consists of catheterizing the patient and allowing radiopaque contrast (typically cystografin) to drip into the bladder. Under fluoroscopy (real time x-rays) the radiologist watches the contrast enter the bladder and looks at the anatomy of the patient. If the contrast refluxes into the ureters and back into the kidneys, the radiologist makes the diagnosis of vesicoureteral reflux, and gives the degree of severity a score. The exam ends when the patient voids on the table while the radiologist is watching under fluoroscopy. It is important to watch the contrast during voiding, because this is when the bladder has the most pressure, and it is most likely this is when reflux will occur.

Indications

• Recurrent urinary tract infections
• Suspected obstruction (e.g. bilateral hydronephrosis)
• Suspected bladder trauma or rupture

Contraindications

• Untreated urinary tract infection
• Hypersensitivity to contrast media

See also

• Posterior urethral valves
• Benign prostatic hypertrophy