Pediatric Voiding Cystourethrogram

A pediatric voiding cystourethrogram (VCUG) is an x-ray examination of a child's bladder and lower urinary tract that uses a special form of x-ray called fluoroscopy and a contrast material.  Fluoroscopy is a form of real-time x-ray that makes it possible to see internal organs in motion. When the bladder is filled with and then emptied of a water-soluble contrast material, the radiologist is able to view and assess the anatomy and function of the bladder and lower urinary tract.

This examination is often recommended after a urinary tract infection to check for a condition known as vesicoureteral (VU) reflux.  This is an abnormality in either a valve or the ureters (the tubes that carry urine from the kidneys to the bladder) that allows urine to flow backwards. In mild cases urine backs up into the lower ureter. In severe cases it can back up into the kidney. Usually, children with this condition are born with it. 

Consult Your Physician

You should inform your physician of any medications your child is taking and if he or she has any allergies, especially to contrast materials. Also inform your doctor about recent illnesses or other medical conditions.

Exam Preparation

Your child does not need to fast or wear special clothing. Explain to your child what will happen during the examination so that there will be no confusion about what is expected. Your child will have to remove all clothing and wear a gown.

The Exam

Fluoroscopy uses a continuous or pulsed x-ray beam to create a sequence of images that are projected onto a fluorescent screen, or television-like monitor. When used with a contrast material, which clearly defines the area being examined, this special x-ray technique makes it possible for the physician to view joints or internal organs in motion. Still images or movies are also captured and stored electronically on a computer.

The technologist begins by positioning the child on the table. Infants and young children may be wrapped tightly in a blanket to help them lie still during the imaging.

An x-ray of the abdomen may be performed before the urinary bladder is catheterized. A catheter is inserted through the urethra, the tube that carries urine from the bladder out of the body. The catheter may be taped to the skin so that it will not be dislodged during the procedure. Then, the bladder is filled with a liquid contrast material. When the bladder is full, the child will urinate around the catheter. The technologist will use fluoroscopy to monitor the filling of the bladder and urination. The radiologist will check to see if any of the liquid contrast material goes backward into one or both ureters and kidneys and whether the shape and contour of the bladder and urethra are normal.

You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained.  A voiding cystourethrogram is usually completed within 30 minutes.

A voiding cystourethrogram may frighten some children. The antiseptic used to clean and prepare for the insertion of the catheter may feel cold. Some children may experience discomfort when the catheter is inserted and the bladder is filled with the liquid contrast material. Most children accept the procedure after an explanation of all of its parts.

A parent may be allowed to stay in the fluoroscopy room to comfort the child. Everyone, except the patient, wears a lead apron in the fluoroscopy room to protect from radiation exposure. A parent who wishes to remain in the fluoroscopy room will be required to wear a lead apron.

After the Exam

A radiologist will analyze the images and send a report to your primary care or referring physician, who will discuss the results with you.


Patients should call to pre-register up to two weeks in advance for any scheduled surgical day and out-patient appointment including most diagnostic tests, lab work and pre-surgical testing. This eliminates the need to wait for an admissions representative upon arrival. Patients can go directly to their point of service. Admissions representatives are available to take calls from 7 a.m. to 7 p.m., Monday and Tuesday, and 7 a.m. to 6 p.m., Wednesday through Friday. 

Please call 508-422-2222.

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