(Cystourethrography, Voiding Cystography, Voiding Cystourethrography, VCUG)

Procedure Overview

What is cystography?

Cystography is a diagnostic procedure that uses X-rays to examine the urinary bladder. Still X-ray pictures or fluoroscopy (a study of moving body structuressimilar to an X-ray "movie") may be used.

During cystography, contrast dye is injected into the bladder. Contrast refers to a substance taken into the body that causes the particular organ or tissue under study to be seen more clearly. X-rays are taken of the bladder, and fluoroscopy may be used to study the bladder emptying while a person urinates (voiding cystography). Cystography may indicate how well the bladder empties during urination and whether any urine backs up into the kidneys (vesicoureteral reflux).

What are X-rays?

X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body structures onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film).

In fluoroscopy, a continuous X-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail.

Other related procedures that may be used to diagnose problems of the bladder include kidney, ureters, and bladder (KUB) X-rays, CT (computed tomography) scan of the kidneys, kidney scan, renal angiogram, renal ultrasound, retrograde cystography, pyelogram (intravenous, antegrade, and retrograde), cystoscopy, cystometry, and uroflowmetry. Please see these procedures for additional information.

Illustration of the anatomy of the urinary system, front view
Click Image to Enlarge

Urinary system parts and their functions

Reasons for the Procedure

Cystography may be performed to assess the cause of hematuria (blood in the urine), recurring urinary tract infections (UTIs), or to assess the urinary system when there has been trauma to the bladder. Cystography may also be used to assess problems with bladder emptying and urinary incontinence.

Obstructions and strictures (narrowing) of the ureters or urethra may be evaluated by cystography. Cystography may be used to assess enlargement of the prostate gland.

Cystography may be performed before and/or after certain surgeries of the spine to assess possible problems with the nerves leading to the bladder from the spine. It may also be performed following trauma to assess for a tear in the bladder wall.

There may be other reasons for your physician to recommend cystography.

Risks of the Procedure

You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. It's a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your physician. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.

If you're pregnant or suspect that you may be pregnant, you should notify your physician. Radiation exposure during pregnancy may lead to birth defects.

Patients who are allergic to or sensitive to medications, contrast dyes, local anesthesia, iodine, or latex should notify their physician.

Patients with kidney failure or other kidney problems should notify their physician.

Bladder infection may occur as a result of placing a catheter into the bladder for the procedure. Insertion of a catheter into the bladder may also cause bleeding or hematuria.

Situations in which cystography is contraindicated include, but are not limited to:

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Certain factors or conditions may interfere with the results of the test. These may include, but are not limited to:

Before the Procedure

During the Procedure

Illustration of retrograde cystography
Click Image to Enlarge

A cystography procedure may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, a cystography follows this process:

  1. You'll be asked to remove any clothing, jewelry, or other objects that might interfere with the procedure.
  2. If you're asked to remove clothing, you'll be given a gown to wear.
  3. You'll be asked to empty your bladder prior to the procedure.
  4. You'll lie on your back on the X-ray table.
  5. A catheter will be inserted into your bladder for injection of the contrast dye into the bladder.
  6. A kidney, ureter, and bladder (KUB) X-ray will be taken to verify that the urinary system is visible. With male patients, a lead shield will be placed over the testes to protect the gonads from the X-rays.
  7. The contrast dye will be injected into the bladder through the catheter. After the dye has been injected, the catheter tubing will be clamped to prevent drainage of the dye from the bladder.
  8. X-rays will be taken while the dye is being injected and afterward. You may be asked to change position for different X-ray views of the urinary system.
  9. If a voiding cystography is requested, the catheter will be removed and you'll be asked to urinate. X-ray or fluoroscopy films will be taken while you urinate. If you're unable to urinate while lying down, you may be allowed to sit or stand up.
  10. If a voiding cystography is not performed, the catheter will be removed after all required X-ray views have been taken.

After the Procedure

There is no special type of care required after a cystography. You may resume your usual diet and activities, unless your physician advises you differently.

You should drink additional fluids for a day or so after the procedure to help eliminate the contrast dye from your system and to help prevent infection of the bladder.

You may experience some mild pain with urination or notice a pink tinge to your urine for a day or two after the procedure. This is to be expected after insertion of the catheter into your bladder. However, if the pain increases or persists longer than two days, notify your physician.

Also, notify your physician to report any of the following:

Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online Resources

The content provided here is for informational purposes only, and wasn't designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we don't control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American Cancer Society

American Urological Association

National Cancer Institute

National Institutes of Diabetes and Digestive and Kidney Diseases

National Institutes of Health (NIH)

National Kidney Foundation

National Library of Medicine


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