Voiding cystourethrogram
kyla Isabel J. Cortuna
URINARY SYSTEM
Essential for waste removal, fluid and KIDNEY
electrolyte balance, blood pressure regulation
and other critical bodily functions.
URETERS
MAJOR COMPONENTS
BLADDER
kidneys
ureters
bladder URETHA
urethra
KIDNEY
One of a pair of organs in the abdomen
Kidneys control the levels of many substances in the
blood. Kidneys help to control your blood pressure.
URETER
There are two ureters, one attached to each
kidney. The upper half of the ureter is
located in the abdomen and the lower half
is located in the pelvic area.
BLADDER
Is a hollow, stretchy organ in the lower part
of your abdomen that stores urine before it
leaves your body through your urethra.
URETHRA
The tube through which urine leaves the
body. It empties urine from the bladder.
UROGRAPHY
radiographic study of the renal drainage or
collecting system using contrast media.
TYPES OF UROLOGIC
PROCEDURES
ANTEGRADE UROGRAPHY
- cm is administered directly in the kidney and
flows in normal direction
RETROGRADE UROGRAPHY
- cm is introduced against the normal flow
VOIDING
CYSTOURETHROGRAPHY
(VCUG)
visualization of the urinary bladder and
urethra during the process of urination
(voiding)
reflux grading
VCUG - AP
VOIDING
CYSTOURETHROGRAPHY
INDICATIONS CONTRAINDICATIONS PREPARATION
vesicoureteral reflux related to the no patient
recurrent lower UTI catheterization of the preparation
bladder trauma urethra
fistula
strictures
VCUG
Patient is in supine position
• scout film is obtained: KUB AP
• urethral catheter is inserted, urine is drained
Filling Phase:
• cm is administered
• x-ray is obtained usually in 50cc intervals until
bladder is at full capacity
AP & AP Obliques
Post-Filling Phase:
• catheter is removed
• patient is instructed to urinate
• recording a series of images while the patient is
voiding
AP and AP Obliques
• RPO (when requested)
• LPO (when requested)
VCUG SHOWING UNILATERAL REFLUX
Fistula diagnosed by VCUG. (a) Rectovesical fistula. (b) Rectoprostatic
fistula. (c) Rectobulbar fistula
VESICOURETERAL REFLUX (VUR)
GRADING
Grade 1 - ureter only
Grade 2 - ureter up to kidney without dilation
Grade 3 - ureter up to kidney with mild dilation
Grade 4 - with dilation of the ureter without twisting, and loss of
sharp calyceal fornices of the kidney
Grade 5 - with twisted and significant dilation of the ureter and
kidney
CASE STUDY 1: NEUROGENIC BLADDER
Px history: Poor urinary stream. History of spinal trauma.
Px data: 15-years old - Male
SCOUT: AP KUB Filling phase:
Supine
Filling phase cont.
CASE DISCUSSION:
Findings on VCUG in a 15 years old
patient with a history of spinal trauma
are most consistent with a neurogenic
bladder, a term applied to a
dysfunctional urinary bladder that
results from an injury to the central or
peripheral nerves that control and
regulate urination.
THANK YOU!!!
AMANG FOR
6MONTHS