Hi, my name is Dr. Scott Cole. I am one of the radiologists here at Mayo Clinic
Health System Eau Claire. Your doctor has ordered a test for your child called
a Voiding CystoUrethroGram or (VCUG). A (VCUG) is a series of x-rays that use
liquid, called contrast, to see real-time pictures of your child's bladder and
connecting tubes, which are called ureters. These pictures will show how
well your child's bladder and ureters are working. Whether your child's bladder
is functioning normally, or if the urine is moving backwards towards the kidneys
during urination, which is called reflex. This test usually takes around
30 minutes.
We find that our parents are more satisfied when they understand what
their child will feel, see, and do during the test. It is our hope that this video
will provide you with that necessary information and will also prepare you to
take care of your child after the test. Since parents give their children the
best support, we feel the better prepared you are the more comfortable you and
your child will feel. This information also enables you to educate and prepare
your child for the procedure. This in turn helps your child cope better during
the test. Please feel free to ask questions at any time. We are here to
make your experience at MutiCare, the best we possibly can.
To perform a (VCUG),
a small catheter is placed inside your child's bladder. Some find that this part
of the procedure is not very pleasant, but we minimize the discomfort as much
as possible by respecting the child's privacy and using a numbing gel. Once the
catheter is in place, your child's bladder is filled with a clear liquid,
called contrast. Contrast, which appears under x-ray, allows us to view the flow
of liquid in the bladder. After a series of x-rays are taken, your child is asked
to pee and the catheter is removed while they urinate.
You may have several
different people working to take care of your child during the test. A
technologist may take a patient history and also assists a radiologist. The
radiologist will take the x-ray pictures and will be in charge of the test. And a
radiology nurse will be in charge of preparing your child for the catheter,
and inserting it, and removing it from your child's urethra.
Before the test,
your child will change from street clothes into a gown and will be asked to
have a seat on the x-ray table in the testing room. The testing room is kept
darker like a movie theater, to help with the procedure and is kept cool. We have
plenty of warm blankets on hand to make sure your child is comfortable. The x-ray
is positioned above the table and is attached to a monitor.
The radiologist moves the x-ray machine into a variety of positions and reviews
the photographs in real-time on the monitor.
We recommend that you make
arrangements for other children to stay at home. This makes it possible for you
to focus on your child during the test. We encourage parents to stay in the room
with your child and help comfort them throughout the exam. For your safety you
will be asked to wear a lead apron. If you are pregnant, or if there is a chance
you are pregnant, we will have you stay behind a window or outside the room for
your safety. And we suggest that someone else who knows your child be with them
in the room. A Child Life Specialist may be on hand to help support your child
during the test. They are trained to help prepare your child for the test, answer
any of their questions, and to use activities that help your child cope
during the test, such as blowing bubbles, counting, reading a book, or imagining a
fun place to be. We encourage you to bring any special items from home such
as an iPod, Gameboy, or blanket to help distract your child during the test.
For babies under the age of three, a special device may be used to hold your infant
safely and securely as they are turned from side to side during the test. This
does not cause pain, but they may feel confined and get upset and cry during
this time. Feel free to use a pacifier, a blanket, or just the sound of your voice
to comfort them during the test. Before the test begins your child will be asked
to position their body in a specific way. girls will be asked to make frog legs or
butterfly wings. This is when their knees are bent out with the bottoms of their
feet touching, as shown here. Boys will be asked to put their legs straight out and
rest upon them. During the procedure, whenever possible, your child's privacy
will be respected. When your child is ready to get started
a nurse will start by cleaning the private area with an antiseptic soap.
This tends to feel cold and wet, then a lidocaine gel is placed on their
privates, to numb the area to prepare for the catheter. The catheter will be
advanced through the urethra, the opening through which your child pees, and into
the bladder. At this point your child may feel some
discomfort. Children tell us that it feels weird, stings, or pinches a little.
she was really nervous before the test and after the procedure, after everything
was done, she walked out of the room and said mommy that didn't hurt as bad as I
thought it would. While they were doing that I thought it would be different
than that. Then I thought wrong. What did you think it would be like? I thought
it would hurt even more and more. So I thought I would hate this day, but
then I didn't. At this time your child may also feel the urge to pee. This is
quite normal. Your child's job during this part will be to lay still and
practice breathing, counting, or using some of the distracting activities
described earlier. We have found that if you practice distraction and coping
techniques at home before the test, such as breathing or counting, it helps your
child cope better.
After the catheter is in place the radiology assistant will
enter the room, introduce themselves, and start the procedure. You will hear
clicking sounds from the machine as the pictures are taken. At no time will the
machine touch your child. As the test starts the bottle of contrast liquid
will be opened to slowly fill up your child's bladder. Your child will be
turned from their back to the right side and then to the left. Pictures will be
taken for each position. You can talk to your child and help comfort them during
this time. As the bladder is being filled with the contrast liquid, your child may
feel a sensation of coolness. They will also get a strong urge to urinate.
eventually your child will be asked to pee on the table. The catheter will be
removed as the urine is flowing out. For some children, urinating on the table is
the hardest part of the test. Reassure your child that it is okay and that the towels on
the table will catch all the pee. The final x-ray is taken when your child's
bladder is completely empty.
After the test we will ask you to wait until the
x-rays are reviewed to make sure the pictures are clear.
If the test is positive, your doctor will be informed and meet with you to discuss
the plan of care for your child. Please contact your child's doctor for
follow-up information and to discuss any questions that you may have about the
tests.
At home your child may return to their normal
daily activities. Please encourage your child to drink extra fluids like water
and juice. This helps to flush the contrast liquid from their bladder. You
may notice a pink color the first time your child pees, which is very
normal. Also normal, is complaining of some
burning or mild irritation from the catheter. Sitting in warm bath water can
be soothing. Just be sure not to use oil or bubble bath as this may cause further
irritation. It is rare but some children may have a reaction to the contrast
liquid used during the test. Call your child's doctor immediately if you notice
any of the following symptoms: a fever over 101 degrees,
if their pee is bright red in color, if they do not urinate for four to six
hours from the time the catheter was removed, if they continue to complain of
burning while urinating 24 hours after the test, or if they continue to have
pink colored urine. If your child was given medicine to help them relax for
the exam, you will be given written instructions on what to expect and how
to care for your child at home.
We hope this video has helped to prepare you and
your child, by giving you a better understanding of what happens during a
(VCUG). Feel free to ask questions of the staff
at any time during the process. We are here to make your experience the best we
possibly can. Thank you