When Is a Voiding Cystourethrogram (VCUG) Needed? - GoodRx (2024)

A voiding cystourethrogram (VCUG) is a common imaging study that lets healthcare providers look at the urinary system, including the bladder, urethra, ureters, and parts of the kidney. The special thing about a VCUG is that it checks how the urinary system is working in real time.

While medical procedures can feel daunting, getting through VCUG is easy with the right preparation. And there are real benefits. A VCUG can answer questions about how the bladder and lower urinary system are working before your eyes.

Why are voiding cystourethrograms performed?

There are several reasons why someone may need a VCUG.

Diagnose urinary reflux

A VCUG is the gold standard for diagnosing urinary reflux. Urine flow is supposed to go in one direction: from the kidneys down the ureters into the bladder and then out the urethra.

One-way valves in the bladder prevent urine from flowing back up the ureters and into the kidneys. But, for some people, these valves don’t work very well and urine can flow backward. This is urinary reflux, a condition that can lead to multiple urinary tract infections (UTIs) and even kidney scarring. A VCUG can find urinary reflux in real time so that people can start treatment and prevent further infections.

Look at the urinary tract

A VCUG can give a picture of someone’s urinary system and how well their bladder drains. Children may need a VCUG if there’s concern about how their urinary tract formed before they were born. Children or adults may need a VCUG to look at their urinary system after they’ve had a major injury or surgery in the area.

Check bladder function

When it’s not clear why someone has incontinence, a VCUG can provide helpful information on how the bladder is working. A VCUG can also help diagnose conditions that keep the bladder from draining completely, like bladder obstruction.

How is a VCUG done?

A VCUG is usually done at a hospital or specialized outpatient imaging center.

A VCUG is done with fluoroscopy. This is a special type of imaging study that uses an X-ray to take pictures of dye (contrast material) as it moves through the urinary tract. The images appear on a screen, so you and the radiologist can see what’s happening in real time. The entire study takes about 30 minutes.

For a VCUG, a provider will ask you to remove all of your clothing, including underwear, and change into a hospital gown. Then you’ll lie down on your back on the X-ray table.

A provider will place a urinary catheter into your bladder. This is a small, flexible tube that goes into your urethra. This step can be a little uncomfortable, but once the catheter is in, you won’t feel any discomfort.

The dye goes into your bladder through the catheter. You will get enough dye to completely fill your bladder. Once your bladder is full, the technologist will take X-rays of your bladder. This will show the size and shape of your bladder.

Because your bladder will be full, you’ll feel like you have to pee. At this point, it’s really important that you hold it in and keep still so that your X-rays are as clear as possible.

Once the X-rays are done, the provider will ask you to empty your bladder. While that may sound like great news, it can be a bit tricky since you're lying down and other people are in the room. As you’re peeing, the technologist will take more X-rays until your bladder is empty. This will show the direction your urine moves in, the shape of your ureters and urethra, and if your bladder empties completely when you urinate.

Once you’re done peeing, the healthcare provider will remove the urinary catheter. The test is over. Sometimes, the radiologist is in the room for the procedure. In that case, you’ll know your results right away.

How do you prepare for a VCUG?

There’s nothing specific you need to do to get ready for a VCUG.

If your child is having a VCUG, keep in mind that studies show that VCUGs are one of the most stressful urologic tests for children and their parents.

Children may be afraid of the catheter, but they may also be afraid of the unknown. Preparing your child can help relieve some of the stress and anxiety.

Many centers have child-life specialists who can offer videos and pamphlets you can go over with your child before the procedure. And the child-life specialist can go over the steps with your child using a doll and materials to demonstrate the VCUG.

If your child is very young or will have a hard time staying still, they may benefit from sedation, a type of anesthesia. This lets your child stay in a twilight state during the VCUG. If your child needs sedation, they will not be allowed to eat or drink for several hours before the VCUG. They will also need to be monitored for about 1 hour after the VCUG to make sure the sedation has worn off.

What to expect after a VCUG

You should feel completely normal after your VCUG. You may notice that your urine looks a bit pink for 1 to 2 days. This is due to irritation and mild bleeding from the urinary catheter.

Complications after a VCUG are rare, but they can happen. Call your healthcare provider right away if you notice any of these symptoms:

• Bladder spasms

• Heavy bleeding with urination

• Pink-colored urine or bleeding that lasts more than 48 hours

• Pus in your urine

• Pain with urination

• Inability to urinate or feeling like your bladder doesn’t fully empty

• Groin, back, or stomach pain

If you didn’t get your VCUG results during your procedure, you should get them within a few days. The healthcare provider who ordered your test may call you with the results. If your healthcare system has a patient portal, the results will be immediately released to your account when they’re available.