Voiding Cystourethrogram In Children

What you should know

  • Voiding cystourethrogram (sis-to-u-re-THRO-gram) (VCUG) is an x-ray procedure to look for problems in your child's urinary system. The urinary system is made up of the kidneys, ureters, bladder, and urethra. The urine flows from the kidneys down through tubes called ureters. From the ureters, the urine goes down and is stored for a short time in the bladder. Urine passes out of the body through another tube, called the urethra. VCUG is used in children with urinary tract infections, trouble passing urine, or nerve problems in their bladder. It is also done to check congenital (born with) kidney problems, kidney stones and dilatations (widening), and bladder trauma.

  • During your child's procedure, the x-ray pictures will show how well the bladder, urethra, and ureters are working. A small bendable catheter (tube) is placed into the bladder through the urethra. In boys, the tube is passed through the penis. The passage of the catheter may cause discomfort, particularly in children who are unable to relax. Contrast medium (dye) is slowly dripped through the tube to fill the bladder. When the bladder is full, your child is asked to void (pass urine). X-ray pictures are taken while voiding occurs. Having a VCUG done on your child may diagnose his disease so proper treatment may be given.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

  • The voiding cystourethrogram may carry certain risks. Your child's bladder may get injured while having the procedure. Problems may happen after the procedure, such as infection or bleeding. The VCUG may expose your child to a long period of radiation. It may also cause your child physical and emotional trauma. Even after the VCUG, your child's disease may not be diagnosed. Your child's caregiver may need to do more procedures.

  • If your child does not undergo the procedure, his condition may not be diagnosed properly. Your child's pain and other symptoms may get worse. Frequent urinary tract infections may cause problems in his kidneys. It may lead to hypertension (high blood pressure) and end-stage kidney diseases. Call or ask your child's caregivers if you are worried or have more questions about your child's procedure and condition.
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Getting Ready

The week before your child's procedure:

  • Tell your child's caregiver about any medicines your child is taking. Ask your child's caregiver about any medications your child should or should not take before the procedure.

  • Dye will be used during your child's procedure. People who are allergic to iodine or shellfish (lobster, crab or shrimp) can also be allergic to some dyes. Tell your caregiver if your child has allergies to any food, medicine, rubber or dye.

  • Tell your child's caregiver if your child has a congenital heart problem. Your child may be given antibiotic medicines to prevent bacterial endocarditis. Bacterial endocarditis is an infection in the valves of the heart.

  • Your child may need to have urine tests before the procedure. If your child has a urinary tract infection, the procedure may be done some other time after his treatment. Ask your child's caregiver for other tests your child may need.

  • You may need to talk to your child about the procedure. A detailed explanation of the procedure may decrease your child's anxiety (fear) and help him prepare for it. A role play preparation of the procedure performed on dolls or soft toys may help him understand the procedure. Ask your child's caregivers for more information on how you can help your child. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your child's procedure:

  • Your child should get a good night's sleep on the night before the procedure.

  • Ask caregivers about directions for eating and drinking.

The day of your child's procedure:

  • Write down the correct date, time, and location of your child's procedure.

  • Ask your child's caregiver before giving your child any medicine the day of the procedure. Bring the pill bottles or a list of your child's medicines with you to the hospital.

  • Your child's caregiver will tell you what your child can and cannot wear the day of the procedure.

  • An anesthesiologist may talk to you before your child's procedure. This is the caregiver who gives the medicine to help control pain during your child's procedure.

  • You or a close family member will be asked to sign a legal piece of paper (informed consent). It gives a caregiver permission to do the procedure. Be sure all of your questions have been answered before you sign this form.

Treatment

What will happen:

  • You may be asked to help your child change into a hospital gown. Your child will be taken on a bed or in a crib to the x-ray room. An x-ray of the abdomen (belly) may be taken before the procedure. Your child may get medicine called local anesthesia to control the pain or discomfort. A caregiver may use this medicine to numb the area of your child's body where the catheter (tube) will be inserted. You may be asked to help your child's caregiver by holding your child while the procedure is being done. The urethral opening will be cleaned with a special liquid.

  • During your child's procedure, a catheter will be inserted gently in your child's urethra. The catheter will be applied with a lubricant before it is inserted inside the urethra. It will be inserted gently and slowly until urine comes out from the tube. This will be the signal when to stop inserting the catheter. The other end of the tube will be attached and secured with a surgical tape on your child's thigh or abdomen to keep it in place. Dye will be slowly dripped through the tube to fill the bladder. Your child will be asked to void (pass urine) when the bladder gets full. X-ray pictures will be taken before, during, and after voiding.

After your child's procedure:

Your child may be able to go home after the procedure. If not, your child will be taken back to a room in the hospital. Your child may have some pain passing urine after his procedure.

Contact a caregiver if

  • You cannot make it to your child's procedure appointment.

  • Your child has a fever.

  • You have questions or concerns about your child's procedure.

Seek Care Immediately if

  • Your child has a fever.

  • The problems for which your child is having the procedure get worse.

  • Your child has nausea (upset stomach) or vomiting (throwing up).

  • Your child has difficulty in urinating or has pus coming out from his urethra.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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