Voiding cystourethrogram for females (1442)

Female

Your child has been scheduled for an x-ray on (date)______________ at (time)______________ in the Imaging (Radiology) Department  on the first floor of Children’s Wisconsin Hospital.

Please stop at a Welcome desk for a badge and directions.

Come to the hospital at least 15 minutes before your child’s appointment time. 

What is a Cystourethrogram?

A cystourethrogram is a special x-ray to see the bladder and the urethra. The urethra is the opening from the bladder to the outside of the body. This test will also show how these work when your child pees (urinates).

The VCUG checks for vesicoureteral reflex (VUR). VUR is a backflow of urine from the bladder to the kidney(s). It can cause kidney infections in children with urinary tract infections.

What do I need to know before the VCUG?

You will be given instructions when your appointment is scheduled. 

When you come to Imaging, someone will greet you. Your child will put on a hospital gown and robe. Then you will wait in the waiting area. A person skilled in taking x-rays, called a technologist, will come and talk with you about the test. Please be sure to ask any questions you have. 

How is it done?

• Your child will lie on an x-ray table and will need to take off her underwear. She may feel embarrassed because parts of her body will be uncovered for this test. Your child will be kept covered as much as possible.
• The nurse and doctor will wear gloves for this test. They will wash where your child pees using a special soap and water, which feels very cold. A small and flexible tube, called a catheter will be put in the urinary opening. Your child may feel some discomfort. A special liquid, called contrast will be put through the tube so that the doctor can see your child’s insides with x-ray. When your child feels like she really has to pee, x-rays will be taken. The tube will then be taken out. Your child will be able to pee while more x-rays are taken.
• Most often the test takes about 30 minutes. When it is done, the radiologist will check the x-rays while you wait.
• What do I need to know after the VCUG?
• Your child may feel uncomfortable using the bathroom after this test. It may help to have her sit in a warm bathtub. Ask the doctor or nurse if you may give Tylenol® for discomfort.
• Have your child drink plenty of liquids. 

Results

The radiologist looks at all films at the end of each test. A report is sent to your child’s doctor. The radiologist may contact your child’s doctor before you leave the hospital. The doctor will discuss the results with you.

Tips for preparing your child for a VCUG

Children cope better when they understand what is happening and why. Getting a child ready for medical procedures in child-friendly terms can reduce fear and anxiety. 

Toddler

• Start the day before the VCUG.
• Tell your child that you both will be going to Children’s Wisconsin. 
• Tell your child that a picture will be taken. The pictures will let the doctors see how the inside of her body works.
• Let your child know that a nurse or doctor will be touching her private area (or other language you use to describe this area). Tell her that it is okay for them to do this.
• Let your child pick out and bring a favorite comfort item to help her feel safe. This might be a toy, book or blanket, 
• Remind your child that you will be close. Parents are encouraged to stay with child during procedure.

Preschool

• Start 1 to 3 days before the VCUG.
• Tell your child that you both will be going to Children’s Wisconsin.
• Tell your child that she will have pictures taken. The pictures will show the doctors what the inside of her body looks like.
• Talk to your child about why the pictures are being taken. For example, “The doctors are taking pictures to see how your body works when you go to the bathroom.”
• Tell your child that before the pictures are taken, a nurse will use cold, brown soap to clean her private area (or other language you use to describe this area). The nurse will put a small, bendy tube inside the hole where her pee comes out.
• Let your child know that she will feel like she has to go the bathroom when the pictures are being taken. Tell her to tell the nurse or doctor when she cannot hold it anymore. For example, “When you feel like you have to pee really bad, let the nurse or doctor know. They will ask you to go to the bathroom while lying down, and this is OK.” 
• Tell your child that the small tube will slide out as she goes to the bathroom.
• Remind your child that you will be close. Encourage her to ask questions.

School age

• Start a few days before the VCUG.
• Tell your child that you both will be going to Children’s Wisconsin.
• Tell your child that special pictures, called X-ray pictures will be taken. The pictures show the doctors how her bladder and kidneys are working when she goes to the bathroom.
• Tell your child what she may see and feel during the important steps of the VCUG. For example, “The nurse will use cold, brown soap to clean your private area (or other language you use to describe this area). Then, the nurse will put a small, bendy tube in the hole where your pee comes out.”
• Tell your child that she will start to feel like she needs to go to the bathroom while the pictures are being taken. Tell her that the technologist will ask her to go the bathroom on the table when she can no longer hold her pee. Tell her that the small tube will slide out when she pees.
• Encourage your child to ask questions.

How can I help my child cope?

• Talk to your child. Prepare your child for what to expect during the VCUG. Focus on what she will see and feel. 
• Practice frog leg position. Encourage your child to sit with her knees out and feet touching while watching TV. This will help her feel more comfortable with the position.
• Bring comfort items. Favorite toys, blankets, dolls, or stuffed animals can stay with your child during the VCUG to provide comfort and familiarity.
• Practice deep breathing. For younger children, practice blowing bubbles or blowing out candles on a birthday cake. For older children, model deep breathing and practice taking slow, deep breaths together. Explain that deep breathing can help keep her body calm and relaxed. During the test, you can remind your child of the things you practiced.
• Give your child a job. Ask her to hold still, look at a book, talk to you, or blow bubbles during the VCUG. This will give her a sense of control and will reduce anxiety.
• Use distraction. Have your child look at a book, sing a favorite song, tell stories, or blow bubbles. This can help your child relax during the VCUG.
• Reassure your child. Due to the personal nature of the exam, your child may feel uncomfortable or embarrassed. Tell her that these feelings are natural, but you will be with her the whole time.