Urethrocystography, voiding, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Voiding Urethrocystography
Alternative name: Voiding Cystourethrography (VCUG)
Summary
Voiding urethrocystography is a radiological procedure that uses X-rays to visualize the urinary bladder and urethra while the patient is urinating. It helps identify abnormalities in the flow and structure of the urinary system.
Purpose
Voiding urethrocystography is primarily used to:
- Diagnose urinary reflux, where urine flows backward from the bladder to the kidneys.
- Identify structural abnormalities, such as blockages or strictures.
- Evaluate post-surgical outcomes in the urinary tract.
Indications
This procedure is indicated for patients with:
- Recurrent urinary tract infections.
- Suspected vesicoureteral reflux (VUR).
- Unexplained urinary symptoms, such as difficulty urinating or incontinence.
- Previous urinary tract surgeries requiring follow-up imaging.
Preparation
- Generally, patients are advised to drink plenty of fluids before the procedure.
- In some cases, antibiotics may be prescribed to prevent infection.
- A preliminary bladder scan or ultrasound may be conducted prior to the procedure.
Procedure Description
- The patient lies on an X-ray table, and a urinary catheter is inserted into the bladder.
- A contrast dye is introduced through the catheter to fill the bladder.
- X-ray images are taken while the bladder fills and during urination to capture the functional aspects of the urinary tract.
- The catheter is removed once sufficient images are obtained.
Duration
Typically, the procedure takes about 30 to 60 minutes.
Setting
Voiding urethrocystography is performed in a radiology department, usually within a hospital or outpatient imaging center.
Personnel
- Radiologist (performs and supervises the imaging process)
- Radiologic technologist (assists with imaging and catheter placement)
- Nurse (assists with patient preparation and comfort)
Risks and Complications
- Exposure to radiation, though minimal.
- Possible urinary tract infection (UTI).
- Discomfort or minor pain during catheter insertion.
Benefits
- Accurate diagnosis of urinary tract abnormalities.
- Non-invasive with quick visual results.
- Helps guide appropriate treatment plans based on precise diagnostic information.
Recovery
- Patients can typically return to normal activities immediately after the procedure.
- Increased fluid intake is recommended to flush out the contrast dye.
- Follow-up instructions may include observing for signs of urinary infection.
Alternatives
- Renal ultrasound: Less invasive but may not provide detailed functional information.
- MRI urogram: Offers detailed imaging but is more expensive and less commonly used.
- CT scan: Provides comprehensive imaging but involves higher radiation exposure.
Patient Experience
- Patients may feel mild discomfort during catheter insertion and urination.
- There may be a temporary increase in the need to urinate after the procedure.
- Any pain is usually minimal and can be managed with over-the-counter pain relievers if needed.
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