Scribd
Upload
20 views20 pages

Cystourethrogram One Hour Class

Cystourethrogram (MCUG/VCUG) is an imaging study used to evaluate the bladder and urethra, primarily indicated for recurrent urinary tract infections and suspected vesicoureteral reflux. The procedure involves catheterization, contrast dye instillation, and fluoroscopy to capture images during bladder filling and micturition. Care must be taken to avoid risks such as infection and urethral trauma, and post-procedure care includes encouraging fluid intake and monitoring for complications.

Uploaded by

Somesh Chandel
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
20 views20 pages

Cystourethrogram One Hour Class

Cystourethrogram (MCUG/VCUG) is an imaging study used to evaluate the bladder and urethra, primarily indicated for recurrent urinary tract infections and suspected vesicoureteral reflux. The procedure involves catheterization, contrast dye instillation, and fluoroscopy to capture images during bladder filling and micturition. Care must be taken to avoid risks such as infection and urethral trauma, and post-procedure care includes encouraging fluid intake and monitoring for complications.

Uploaded by

Somesh Chandel
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Cystourethrogram

(MCUG/VCUG)
Diagnostic Utility, Procedure &
Interpretation
Objectives
• Understand indications for cystourethrogram
• Learn the procedure step-by-step
• Identify normal and abnormal findings
• Understand risks and precautions
• Case-based discussion and image review
What is a Cystourethrogram?
• Imaging study to evaluate the bladder and
urethra
• Uses fluoroscopy and contrast dye
• Types:
• - MCUG (Micturating Cystourethrogram) –
pediatric use
• - VCUG (Voiding Cystourethrogram) –
adult/functional assessment
Indications
• Recurrent urinary tract infections
• Suspected vesicoureteral reflux (VUR)
• Posterior urethral valves (PUV) in boys
• Lower urinary tract obstruction
• Incontinence/voiding dysfunction
Contraindications
• Active urinary tract infection (UTI)
• Allergy to contrast media
• Severe urethral trauma (relative
contraindication)
Anatomy Review
• Diagram of male and female urinary tract
• Label bladder, urethra, ureters
• Emphasize urethral differences in children
Equipment & Materials
• Fluoroscopy unit
• Sterile catheter
• Iodinated contrast agent
• Collection set, gloves, drapes, consent form
Preparation
• Informed consent
• Rule out UTI (urine culture)
• Explain procedure to patient/parent
• Ensure sterile environment
Procedure Overview
• 1. Catheterize bladder
• 2. Instill contrast under fluoroscopy
• 3. Take images during filling phase
• 4. Patient voids – take images during
micturition
• 5. Remove catheter post-procedure
Key Views Captured
• AP view of bladder filling
• Oblique view of ureters
• Micturition phase (especially lateral view in
boys)
• Post-void residual
Normal Findings
• Smooth bladder outline
• No reflux of contrast into ureters
• Complete bladder emptying
Abnormal Findings: VUR
• Retrograde filling of ureters
• Graded I–V (show diagram of grading)
• Bilateral vs unilateral reflux
Posterior Urethral Valve
• Dilated posterior urethra
• Thin bladder wall
• Obstructive pattern
• Common in infant boys
Urethral Stricture/Diverticulum
• Narrowed urethra
• Outpouchings of contrast
• Usually seen in adults or post-trauma
Neurogenic Bladder
• Large capacity bladder
• Incomplete emptying
• Trabeculated wall
Risks & Complications
• Infection
• Urethral trauma
• Allergic reaction to contrast (rare)
• Radiation exposure
Radiation Dose & Protection
• ALARA principle (As Low As Reasonably
Achievable)
• Lead shielding
• Minimize fluoroscopy time
Post-Procedure Care
• Encourage fluids to flush contrast
• Observe for signs of UTI
• Mild hematuria may occur
Case Study Examples
• Show 2–3 cases with MCUG/VCUG images:
• 1. Normal
• 2. VUR
• 3. Posterior urethral valve
Summary
• MCUG/VCUG is crucial for diagnosing urinary
tract pathology
• Indicated mainly in recurrent UTI or
obstruction
• Involves contrast instillation and fluoroscopy
• Must be performed with care to avoid
infection or trauma

You might also like