Cystography.com

A Cystography, or a cystogram, is a specialized medical imaging procedure that uses X-rays and a contrast dye to create detailed pictures of your urinary bladder and urethra. The most common type is a Voiding Cystourethrography (VCUG), which is crucial for diagnosing conditions like Vesicoureteral Reflux (VUR). If you or a loved one are scheduled for this exam, you've come to the right place for reliable, easy-to-understand information. This guide will walk you through every step of the bladder imaging procedure, from initial preparation to understanding your final results.

Want to know what the difference is? Read our deep dive: Cystography vs. VCUG: Key Differences Explained.

Essential Pre-Procedure Checklist

Proper preparation ensures a smooth and accurate procedure. Follow these steps carefully to prepare for your bladder X-ray.

• Medication Review: Discuss all current medications with your provider, especially blood thinners or diabetes medications.
• Allergy Disclosure: Inform the technician of any allergies, especially to iodine, contrast dye, or latex.
• Clothing: Wear comfortable, loose-fitting clothes. You will change into a hospital gown before the exam begins.
• Hydration: Follow any specific instructions from your doctor regarding fluid intake before the procedure.

For specific guidelines for pediatric patients, visit our dedicated page: VCUG Preparation for Children.

Phase 1: Catheterization and Contrast Administration

The cystogram procedure begins with the careful insertion of a small urinary catheter into the bladder through the urethra. This is the part that is usually the most uncomfortable. The contrast dye is then slowly allowed to flow into the bladder until it is full. The X-ray technologist will capture initial images of the filled bladder to check for any structural issues.

Phase 2: Voiding (The VCUG Part)

You will be asked to empty your bladder (void) while the radiologist takes rapid X-ray images. This is the crucial step of the Voiding Cystourethrography (VCUG), as it shows if urine flows backward from the bladder toward the kidneys (a sign of Vesicoureteral Reflux). You'll be encouraged to relax and void naturally.

Concerned about the X-ray dose? Learn about Radiation Safety in Diagnostic Imaging.

The radiologist will analyze the images immediately. The primary reason for a VCUG is to check for Vesicoureteral Reflux (VUR), where the contrast dye is seen moving from the bladder up the ureters towards the kidneys. If VUR is detected, it is typically graded from I (mild) to V (severe). Understanding your VUR grade is vital for treatment planning.

For official medical details on VUR grading, consult a trusted medical organization: NIDDK Information on VUR (External Link).

If your VCUG results are positive for VUR, the severity is categorized using a five-grade system. This grade dictates the approach to treatment, ranging from observation and antibiotics to surgical intervention.

• Grade I:

  Reflux into the ureter only, which does not reach the kidney (renal pelvis).

• Grade II:

  Reflux up to the renal pelvis, but without dilation (widening) of the ureter or the collecting system.

• Grade III:

  Reflux causes mild-to-moderate dilation of the ureter and the collecting system, but the fornices (calyx cups) are still sharp.

• Grade IV:

  Moderate dilation and tortuosity (twisting) of the ureter, with mild blunting of the renal calyces (the cups that collect urine).

• Grade V:

  Severe dilation and tortuosity of the ureter, with significant blunting of the renal calyces and loss of normal kidney structure.