The voiding cystourethrogram test is an X-ray imaging test used to examine a patient’s urinary system. The test is performed while the patient voids urine.
The voiding cystourethrogram test is usually done in a hospital’s radiology department by a radiologist or by a x- ray technician. At first the patient’s urinary bladder will be filled with a special type of solution called contrast material and the x-ray is taken. The x-ray includes both abdominal and pelvic area so that the complete urinary system including the urinary bladder, urethra and ureter can be imaged.
As usual, the x-ray image will be black and white. Here the harder parts of the body that does not allow the x-rays to pass through will appear white and the softer parts of the body like muscles, skin etc will appear black. The contrast material that gets filled in the urinary system makes the system appear white and thus visible. The air that gets accumulated in this area will appear black.
The x-ray image will be taken within few minutes and the test will altogether takes only 30 minutes. The test is mostly done in children. The patient will be first taken to a special room where a table and other x-ray equipments are kept and the patient is asked to lie down on the table. At first the technician will take a plain x-ray and after cleaning or washing between the patient’s legs, he will gently insert a thin and flexible rubber tube called catheter into the urethra. This catheter is used to fill the patient’s bladder with contrast material or contrast dye. Once the bladder gets filled with this dye, the urinary system becomes more visible and x-ray images will be taken from various angles. After that the catheter will be removed and the patient is asked to urinate. X-ray images are also taken when the patient passes urine.
The test is based on the principle of fluoroscopy. The contrast dye that moves through the urinary system helps the technician in observing and studying the problems in this area. It is through the x-ray video on screen and through x-ray film that the technician understands the problem.
The Voiding Cystourethrogram Test helps in ruling out the cause of urinary tract infection in patient’s who suffers from recurrent urinary tract infection. It also helps in diagnosing problems like abnormal bladder emptying, congenital problems in the urinary system etc. In males, it helps in diagnosing urethral structure.
The Voiding Cystourethrogram test is also used to detect any structural and functional abnormalities in the urinary system. For example, to observe the size and shape of the bladder, any blockage in the normal passage of urine etc.
The physician may ask to perform this test to diagnose conditions like Vesicoreteral reflux, where the urine sometimes moves back towards kidneys. Sometimes the backward flow might occur just at the time of urination. As the voiding cystourethrogram test is performed while urinating, it helps to detect problems like vesicoreteral reflux.
The test is normally performed in the morning. As the jewelry, buttons and other clothing accessories might interfere with the x-ray imaging, the patient will be asked to remove all the jewelries and clothing and made to wear a hospital gown prior to the test.
The female patients who are pregnant should inform either to the doctor or the x-ray technician as the radiation may sometimes cause harm to the fetus. In unavoidable cases, the x-ray will be carried out with special precautions that help in protecting the baby from harmful effects of radiation.
If the patient has any allergy, especially to the contrast dye used for the test, it should be informed prior to the test.
For smaller children mild sedatives will be given to facilitate the insertion of catheter. In case of older children, explaining them about the test in details especially to keep still while undergoing the test helps in carrying out the test smoothly with out repetition.
There are no specific risks involved. Even though the x-rays are safe, there are some risks involved in the exposure of radiations to the body. The amount of radiation used in the voiding cystourethrogram test is usually very low and are not dangerous for the body. If possible, try to make sure that the technician uses only the minimum amount of radiation necessary to carry out the test properly. Since the x-rays are harmful for the developing babies, it is very important to inform the doctor or the x-ray technician if you are pregnant so that special care and precautions could be taken.
A normal result implies that the urinary system is normal in size and function.
Abnormal results mostly seen are conditions like urethral structure or narrowing of the urethra in males, enlargement of prostates, neurogenic bladder, appearance of sac like structures called diverticula on uretharal and bladder walls, vesicoreteral reflux (backward flow of urine), Ureterocele etc. The voiding cystourethrogram test also helps in evaluation of problems like urinary tract infection or UTI, alcoholic neuropathy, irritable bladder etc. The abnormal result also infers conditions like autonomic neuropathy, pyelonephritis, chronic bilateral obstructive disorders etc.