This document provides information about a voiding cystourethrogram procedure. It describes how the procedure is performed, including inserting a Foley catheter into the bladder and injecting contrast. Serial x-rays are taken of a full bladder, during voiding, and after voiding to assess for structural issues in the bladder and urethra like reflux or obstruction. The procedure evaluates causes of incontinence, urinary tract infections, and injuries. Risks include infection, reaction to contrast, and perforation of the bladder.

2. VOIDING CYSTO
URETHROGRA
M

4. PATIEND PREPARATION
KUB SCOUT FILM
INSERTION OF FOLEY CATHETER
INTRODUCED WATER
SOLUBLE CM SERIAL FILM-FULL
BLADDER,VOIDING,POST VOID

5. To find the cause of urinary incontinence.
To look for a cause of repeated urinary
tract infections.
To check for structural problems of the
bladder and the urethra.
To look for enlargement (hypertrophy) of
the prostate or narrowing of the urethra in
men (urethral stricture).
To look for injuries to the bladder or
urethra.

6. Blood in the urine after two days.
Pain in the lower part of the tummy
(abdomen).
Signs of a urinary tract infection. These
signs include:

7. Pain or burning upon urination.
An urge to urinate frequently, but usually
passing only small amounts of urine.
Dribbling or leaking of urine.
Urine that is reddish or pinkish, foul-smelling, or
cloudy.
Pain in the back just below the rib cage on one
side of the body (flank pain).
High temperature (fever) or chills.
Feeling sick (nausea) or being sick (vomiting)

8.  PERFORATED URINARY BLADDER
INTRARENAL INFECTION
ANAPHYLACTIOD REACTION

9. THIS INVESTIGATION IS MAINLY DONE
TO ASSESS URETHRA FOR ANY
OUTFLOW OBSTRUCTION AND STRESS
INCONTINENCE
ALSO DONE TO
DEMONSTRATE VESICO – URETERIC
REFLUX ESPECIALLY IN CHILDREN
HOWEVER IT IS CONTRAINDICATED
IN ACUTE INFECTION OF THE BLADDER
(OR) URETHRA.

10. THE PATIENT
MICTURATES IMMEDIATELY
BEFORE THE EXAMINATION
IN CATHETERISED PATIENTS,THE
CATHETER CLAMP IS CAN BE
RELEASED TO DECOMPRESS THE
BLADDER.

11.  SODIUM IODIDE IN
THE CONCENTRATION OF 12% W/V
THE SOLUTION MUST BE STERILE.
PLAIN
FILM OF THE BLADDER IS TAKEN &
REVIEWED BEFORE INJECTION OF
CONTRAST MATERIALS.

12.  SCOUT FILM-15*12
FULL BLADDER-15*12
POST VOID-14*14

13. 
AP- SCOUT
AP-FULL BLADDER
OBLIQUE-URINE
MOMEND
AP- POST VOID

14.  EMPTY BLADDER AP-
(58KV-20MAS)
FULL BLADDER AP-(60KV-
20MAS)
POST VOIDING OBL-
(70KV-35MAS)

15.  A CATHETER IS INTRODUCED INTO THE
BLADDER UNDER ASEPTIC CONDITIONS AND
CONTRAST INTRODUCED INTO THE BLADDER
EITHER BY A DRIP INFUSION OR MANUALLY
THROUGH HUGGINSON`S SYRINGE
WHEN THE
BLADDER IS FULL ,THE CATHETER IS WITH DRAWN
AND FULL BLADDER RADIOGRAPH IS TAKEN IN THE
AP POSITION . THE PATIEND IS
POSITIONED IN THE OBLIQUE POSITION.
THE RADIOGRAPHER IS READY TO
EXPOSE,THE MOMENT URINE IS SEEN ON THE
EXTERNAL MEATUS .

16.  THIS RADIOGRAPH SIZE IS
VARIABLE , IF THE STUDY IS BEING
UNDERTAKEN TO ASSESS VESICOURETERIC
REFLUX , (A LARGE FILM IS USED ) SO AS TO
INCLUDE THE URETERS.
IF THE REGION OF INTEREST IS
THE URETHRA ,
A SMALLER SIZE FILM IS
EXPOSED TO INCLUDE THE BLADDER AND
URETHRA.
GENERALLY RADIOGRAPHS
ARE TAKEN IN RIGHT AND LEFT OBLIQUE
POSITION TO ASSESS THE URETHRA IN ITS
ENTIRE LENTH FREE OF BONY
SUPERIMPOSITION.

17. AFTER EXPOSURE AND VIEWING OF
THESE FILMS
THE PATIEND IS
ASKED TO VOID IN THE TOILED
AND A POST MICTURITION FILM IS
TAKEN TO ASSESS RESIDUAL
URINE.
MODIFICATION HAVE TO BE
MADE FOR CHILDREN AND IN
PATIENDS WITH STRESS
INCONTINENCE.

18. AP PLAIN IMAGE

19. FULL BLADDER

20. 
A: Voiding cystourethrogram (VCUG) showing
symmetrical protrusions of the urinary bladder
bilaterally laterally into the pelvis "Bladder ears"
anomaly
B: Voiding cystourethrogram (VCUG) showing
symmetrical protrusions of the urinary bladder
bilaterally laterally into the pelvis "Bladder ears"
anomaly which appears more prominent on
straining

21. oBLIQUE VOIDING

22. VESICO URETERAL REFLUX

23. Bilateral vesicoureteral reflux. VCUG
showing Grade 4 reflux on the
right (severe blunting of the calyces,
pelvic dilation, and ureteral tortuosity)
and Grade 3 reflux on the left (some
blunting of the calyces).

25. Vesicoureteric reflux
“ This case
illustrates typical bilateral grade
V vesicoureteric reflux without
duplex anatomy or posterior
urethral valves

26. OBLIQUE VOITING