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A VCUG is usually done for recurrent UTIs. The patient will be asked to undress from the waist down (pants and panties), and be given a gown. She will be asked to empty her bladder in the bathroom. Usually, a preliminary x-ray image will be taken. The only way to see the bladder and uterers (the tubes that connect the bladder to the kidney) with x-ray is to introduce a contrast or dye. In order to do that, the patient must be catheterized. The radiologic technologist or possibly a nurse will do this part of the study. Your daughter will be laying on her back, with her knees bent and spread apart. The tech/nurse will clean the outside of the genitilia with a betadine soap and insert a small tube through the urethra to the bladder. This can be very uncomfortable as the tube is passed through the urethra, but once the tube is in place, your daughter will not know it is there. It is important that she try to relax her muscles as the tube is introduced. Tight muscles will make the insertion harder and it will take longer, meaning it will prolong the uncomfortable feeling. Once the tube is in place, the legs are straightened and her gown or even a blanket will be put over her, so that she is not exposed. At that point, the radiologist will enter the room. While watching in real time on a TV screen, the radiologist will start allowing the contrast to fill the bladder, via the catheter. Your daughter will probably be able to see this as well. Eventually, her bladder will start telling her brain that she needs to urinate. We want the bladder to get fairly full. They are looking to make sure the valves at the UPJ (ureteropelvic junction-where the ureters enter the bladder) are competent. They should not open and allow fluid from the bladder to enter the ureters. Once your daughter feels full, she will be asked to pee on the x-ray table. They will put towels between her legs, and she will be covered. Peeing on the table is important, because sometimes with the pressure, the urine will leave the bladder and enter the ureter. IF a patient cannot pee on the table (and some cannot for modesty issues), we will take out the catheter tube and have her pee in the toilet in private. After emptying the bladder, she will be asked to hustle back to the x-ray table for a picture to make sure there is no contrast in the ureters. There really is no side effects post procedure. She will not leak contrast or have pain. So whatever she wants to wear is fine. The worst part of this study is the embarassment of the catheterization. And as long as you are not pregnant, you should be allowed to wear a leaded apron and stay in the room with her, if she wishes.
Another good idea: When they catheterize your daughter, you can get a "clean catch" of urine. Make sure they give you some of this clean catch for testing. When you urinate into a cup, it is possible for contamination from the labia etc. A clean catch is just urine, and nothing else. Our pediatric group in town always wants the parent to bring a clean catch to them so they can test it for bacteria. Find out if this is something they want you to do before the procedure begins. It may save your daughter from having to be catheterized for a clean catch later on.