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Learn About the Voiding CystoUrethroGram (VCUG) Prodedure

Hi, my name is Dr. Scott Cole. I am one of the radiologists here at Mayo Clinic

Health System Eau Claire. Your doctor has ordered a test for your child called

a Voiding CystoUrethroGram or (VCUG). A (VCUG) is a series of x-rays that use

liquid, called contrast, to see real-time pictures of your child's bladder and

connecting tubes, which are called ureters. These pictures will show how

well your child's bladder and ureters are working. Whether your child's bladder

is functioning normally, or if the urine is moving backwards towards the kidneys

during urination, which is called reflex. This test usually takes around

30 minutes.

We find that our parents are more satisfied when they understand what

their child will feel, see, and do during the test. It is our hope that this video

will provide you with that necessary information and will also prepare you to

take care of your child after the test. Since parents give their children the

best support, we feel the better prepared you are the more comfortable you and

your child will feel. This information also enables you to educate and prepare

your child for the procedure. This in turn helps your child cope better during

the test. Please feel free to ask questions at any time. We are here to

make your experience at MutiCare, the best we possibly can.

To perform a (VCUG),

a small catheter is placed inside your child's bladder. Some find that this part

of the procedure is not very pleasant, but we minimize the discomfort as much

as possible by respecting the child's privacy and using a numbing gel. Once the

catheter is in place, your child's bladder is filled with a clear liquid,

called contrast. Contrast, which appears under x-ray, allows us to view the flow

of liquid in the bladder. After a series of x-rays are taken, your child is asked

to pee and the catheter is removed while they urinate.

You may have several

different people working to take care of your child during the test. A

technologist may take a patient history and also assists a radiologist. The

radiologist will take the x-ray pictures and will be in charge of the test. And a

radiology nurse will be in charge of preparing your child for the catheter,

and inserting it, and removing it from your child's urethra.

Before the test,

your child will change from street clothes into a gown and will be asked to

have a seat on the x-ray table in the testing room. The testing room is kept

darker like a movie theater, to help with the procedure and is kept cool. We have

plenty of warm blankets on hand to make sure your child is comfortable. The x-ray

is positioned above the table and is attached to a monitor.

The radiologist moves the x-ray machine into a variety of positions and reviews

the photographs in real-time on the monitor.

We recommend that you make

arrangements for other children to stay at home. This makes it possible for you

to focus on your child during the test. We encourage parents to stay in the room

with your child and help comfort them throughout the exam. For your safety you

will be asked to wear a lead apron. If you are pregnant, or if there is a chance

you are pregnant, we will have you stay behind a window or outside the room for

your safety. And we suggest that someone else who knows your child be with them

in the room. A Child Life Specialist may be on hand to help support your child

during the test. They are trained to help prepare your child for the test, answer

any of their questions, and to use activities that help your child cope

during the test, such as blowing bubbles, counting, reading a book, or imagining a

fun place to be. We encourage you to bring any special items from home such

as an iPod, Gameboy, or blanket to help distract your child during the test.

For babies under the age of three, a special device may be used to hold your infant

safely and securely as they are turned from side to side during the test. This

does not cause pain, but they may feel confined and get upset and cry during

this time. Feel free to use a pacifier, a blanket, or just the sound of your voice

to comfort them during the test. Before the test begins your child will be asked

to position their body in a specific way. girls will be asked to make frog legs or

butterfly wings. This is when their knees are bent out with the bottoms of their

feet touching, as shown here. Boys will be asked to put their legs straight out and

rest upon them. During the procedure, whenever possible, your child's privacy

will be respected. When your child is ready to get started

a nurse will start by cleaning the private area with an antiseptic soap.

This tends to feel cold and wet, then a lidocaine gel is placed on their

privates, to numb the area to prepare for the catheter. The catheter will be

advanced through the urethra, the opening through which your child pees, and into

the bladder. At this point your child may feel some

discomfort. Children tell us that it feels weird, stings, or pinches a little.

she was really nervous before the test and after the procedure, after everything

was done, she walked out of the room and said mommy that didn't hurt as bad as I

thought it would. While they were doing that I thought it would be different

than that. Then I thought wrong. What did you think it would be like? I thought

it would hurt even more and more. So I thought I would hate this day, but

then I didn't. At this time your child may also feel the urge to pee. This is

quite normal. Your child's job during this part will be to lay still and

practice breathing, counting, or using some of the distracting activities

described earlier. We have found that if you practice distraction and coping

techniques at home before the test, such as breathing or counting, it helps your

child cope better.

After the catheter is in place the radiology assistant will

enter the room, introduce themselves, and start the procedure. You will hear

clicking sounds from the machine as the pictures are taken. At no time will the

machine touch your child. As the test starts the bottle of contrast liquid

will be opened to slowly fill up your child's bladder. Your child will be

turned from their back to the right side and then to the left. Pictures will be

taken for each position. You can talk to your child and help comfort them during

this time. As the bladder is being filled with the contrast liquid, your child may

feel a sensation of coolness. They will also get a strong urge to urinate.

eventually your child will be asked to pee on the table. The catheter will be

removed as the urine is flowing out. For some children, urinating on the table is

the hardest part of the test. Reassure your child that it is okay and that the towels on

the table will catch all the pee. The final x-ray is taken when your child's

bladder is completely empty.

After the test we will ask you to wait until the

x-rays are reviewed to make sure the pictures are clear.

If the test is positive, your doctor will be informed and meet with you to discuss

the plan of care for your child. Please contact your child's doctor for

follow-up information and to discuss any questions that you may have about the

tests.

At home your child may return to their normal

daily activities. Please encourage your child to drink extra fluids like water

and juice. This helps to flush the contrast liquid from their bladder. You

may notice a pink color the first time your child pees, which is very

normal. Also normal, is complaining of some

burning or mild irritation from the catheter. Sitting in warm bath water can

be soothing. Just be sure not to use oil or bubble bath as this may cause further

irritation. It is rare but some children may have a reaction to the contrast

liquid used during the test. Call your child's doctor immediately if you notice

any of the following symptoms: a fever over 101 degrees,

if their pee is bright red in color, if they do not urinate for four to six

hours from the time the catheter was removed, if they continue to complain of

burning while urinating 24 hours after the test, or if they continue to have

pink colored urine. If your child was given medicine to help them relax for

the exam, you will be given written instructions on what to expect and how

to care for your child at home.

We hope this video has helped to prepare you and

your child, by giving you a better understanding of what happens during a

(VCUG). Feel free to ask questions of the staff

at any time during the process. We are here to make your experience the best we

possibly can. Thank you