Name of the Procedure:

Injection Procedure for Cystography or Voiding Urethrocystography (VCUG)

Summary

This procedure involves injecting a contrast dye into the bladder to take X-ray images. It helps doctors visualize the bladder and urethra to diagnose and assess urinary tract issues.

Purpose

Cystography and voiding urethrocystography are used to:

• Diagnose bladder and urethra conditions such as vesicoureteral reflux, bladder rupture, or anatomical abnormalities.
• Evaluate symptoms like recurring urinary tract infections (UTIs), incontinence, or blood in the urine.
• Assess the bladder's function and structure, especially after trauma or surgery.

Indications

• Recurrent UTIs
• Unexplained incontinence or urinary urgency
• Blood in urine (hematuria)
• Traumatic injury to the lower abdomen
• Pre-surgical assessment for bladder-related procedures

Preparation

• The patient may need to stop taking certain medications and inform the doctor of any allergies, especially to contrast dye.
• Typically, no fasting is required.
• A preliminary urinalysis may be conducted to check for existing infections.

Procedure Description

1. The patient lies on an X-ray table.
2. The genital area is cleansed with an antiseptic solution.
3. A thin catheter is gently inserted into the urethra and advanced into the bladder.
4. Contrast dye is slowly injected through the catheter to fill the bladder.
5. X-ray images are taken while the bladder is filling and during urination to capture the entire process.
6. The catheter is then removed.

Tools: Sterile catheter, contrast dye, antiseptic solution. Anesthesia: Local anesthesia may be applied to the urethra to minimize discomfort; sedation is generally not required.

Duration

The entire procedure typically takes about 30-60 minutes.

Setting

This procedure can be performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist or urologist
• Radiology technician
• Nurses

Risks and Complications

Common risks:

• Mild discomfort or burning sensation during urination post-procedure
• Allergic reaction to the contrast dye

Rare complications:

• Urinary tract infection
• Bleeding or injury to the urethra or bladder

Benefits

• Precise diagnosis of urinary tract conditions.
• Helps guide appropriate treatments.
• Non-invasive with quick recovery.

Recovery

• Patients can usually return to normal activities immediately.
• Drink plenty of fluids to help flush out the contrast dye.
• Mild pain relievers can be used if needed.
• Follow-up appointment if any abnormalities are found.

Alternatives

• Ultrasound (less detailed but no exposure to contrast dye)
• MRI (does not use X-rays but may not be as accessible)
• CT scan (provides detailed images but involves higher radiation exposure)

Patient Experience

During the procedure:

• Expect mild discomfort during catheter insertion.
• A sensation of fullness or urge to urinate as the bladder fills.

After the procedure:

• Some burning sensation during urination, which should subside within a day.
• Follow post-procedure care instructions for optimal recovery.