http://www.chop.edu/consumer/jsp/division/service.jsp?id=26707

VOIDING VOIDING CYSTOURETHROGRAPHYCYSTOURETHROGRAPHY

WHAT IS A VCUG?WHAT IS A VCUG?

Radiologic investigation underfluoroscopy to Radiologic investigation underfluoroscopy to evaluate;evaluate;

**VU reflux**VU reflux *Bladder disease*Bladder disease *Urethral stenosis, others*Urethral stenosis, others

WHEN TO DO?WHEN TO DO?

UTI---UTI--- clinical febrile UTI+UA+ urine C/S clinical febrile UTI+UA+ urine C/S ** Children <5 years;** Children <5 years; ** U/S + VCUG U/S + VCUG ** Renal U/S (2-3 days after infection)-- Renal U/S (2-3 days after infection)--

abnormal --abnormal -- VCUG +/-IVP (4-6 wks after VCUG +/-IVP (4-6 wks after acute infection) -----abnormal --acute infection) -----abnormal -- antibiotic antibiotic prophylaxis & refer to specialist prophylaxis & refer to specialist

HOW TO DO?HOW TO DO?

Patient preparationPatient preparation KUB scout filmKUB scout film Insertion of foley catheterInsertion of foley catheter Introduced water soluble CMIntroduced water soluble CM Serial film—fullbladder, during urinate, post Serial film—fullbladder, during urinate, post

voidvoid

RADIATION DOSERADIATION DOSE

For a child 5-10 years, effective radiation For a child 5-10 years, effective radiation dose is 1.6 mSv= nature background 6 dose is 1.6 mSv= nature background 6 months.months.

Infant, effective radiation dose is 0.8 mSv= Infant, effective radiation dose is 0.8 mSv= nature background 3 months.nature background 3 months.

COMPLICATIONCOMPLICATION

Perforated urinary bladderPerforated urinary bladder Intrarenal infectionIntrarenal infection Anaphylactoid reactionAnaphylactoid reaction

NORMAL VCUGNORMAL VCUG

NORMAL MALE VCUGNORMAL MALE VCUG

VU REFLUXVU REFLUX

POSTERIOR URETHRAL POSTERIOR URETHRAL VALVEVALVE

IMAGING TECHNIQUE FOR IMAGING TECHNIQUE FOR DETECTION OF DETECTION OF

VESICOURETERAL REFLUXVESICOURETERAL REFLUX Direct Radionuclide Voiding Cystography Direct Radionuclide Voiding Cystography

(DRVC)(DRVC) Voiding Cystourethrography ( VCUG)Voiding Cystourethrography ( VCUG) Voiding Urosonography ( VUS)Voiding Urosonography ( VUS)

THANK YOU FOR THANK YOU FOR ATTENTIONATTENTION