Cystography Periprocedural Care

Updated: Aug 27, 2020
  • Author: Wellman W Cheung, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Periprocedural Care

Equipment

It is important to have all of the following for cystography: 

  • Sterile gloves
  • Lead aprons and thyroid shields for all personnel
  • Sterile catheterization kit with all necessary tubing and tape to secure it in place 
  • Intravenous (IV) pole
  • Urethral catheter – In children, a 5- or 8-French pediatric feeding tube may be used
  • Fluoroscope 
  • Contrast medium – For children, this should be at body temperature to avoid stimulating temperature-sensitive receptors in the mucosa that can alter detrusor muscle tone
  • Urodynamics equipment – Specialized urethral catheters and pressure transducers
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Patient Preparation

Anesthesia

Voiding cystourethrography (VCUG) can cause considerable anxiety, especially in children; the procedure can be done with sedation on a case-by-case basis. According to a systematic review, midazolam was safe and effective, with no interaction with voiding dynamics (0.5-0.6 mg/kg orally 30-45 minutes prior to the procedure or 0.2 mg/kg intranasally prior to the start of the procedure). [6]

Positioning

Urodynamic examinations are done with the patient in the usual position assumed for voiding. The VCUG position depends on the stage of the procedure and on the patient. For catheterization, the patient is supine with the legs in the “frog-leg” position. The voiding phase can be executed in the patient’s normal position for voiding, with the radiologist opting to have the patient in lateral or oblique views depending on his or her preference.

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