Voiding Cystourethrogram (VCUG)

After the patient's bladder is filled with a liquid called contrast material, an X-ray machine sends beams of radiation through the abdomen and pelvis, and images are recorded on special film or a computer. These images help doctors see problems in parts of the urinary system, including the bladder, urethra (the tube connecting the bladder with the outside of the body), and the ureters (the tubes connecting the kidneys to the bladder).

A radiologist takes the X-rays using a technique called fluoroscopy. While the contrast material fills your child's bladder, and then while your child empties the bladder, the radiologist watches an onscreen X-ray video of the liquid moving through the urinary system and a series of X-ray films is recorded.

In general, X-rays are very safe. Although there is some risk to the body with any exposure to radiation, the amount used in a VCUG is small and not considered dangerous. It's important to know that Nemours radiologists use the minimum amount of radiation required to perform the study properly.

 
What does a VCUG show?

A VCUG can show whether the urine is moving in the right direction. Normally, urine flows from the kidneys down to the bladder through the ureters. When urine goes back up toward the kidneys, it's called vesicoureteral reflux (VUR), which a VCUG can detect. Sometimes VUR only occurs while urinating (voiding), which is why the VCUG includes taking X-ray images while the bladder is being emptied.

 
About Sedation

At times, fear, anxiety, and developmental stage of a child contribute to his or her ability to cooperate with medical procedures. Pediatric procedural sedation can be used to decrease discomfort and anxiety for your child.

Sedation is available for VCUG and a separate sedation appointment would be needed to be scheduled prior to the study.

Providing sedation means a child is given medicine to make the child more relaxed. When a child is sedated, he or she may better tolerate a medical procedure and will probably not remember it.

The sedation team aims for mild to moderate sedation, meaning that your child will be relaxed, but awake enough to answer questions and to sense a full bladder.Typical sedatives for this procedure include midazolam (Versed), given orally or as a nasal spray, or nitrous oxide (“laughing gas”) given with a mask. This procedure takes about 10 minutes for catheter placement and bladder filling, and another few minutes for the child to urinate.

Urine Test: Protein

What It Is

A urine protein test measures the total amount of protein in the urine. Once a urine sample is collected, the lab determines the amount of protein in the urine sample. This test is often done as part of a routine urinalysis in which several chemicals in the urine are measured.

Why It's Done

In most healthy people, the kidneys prevent significant amounts of protein from entering the urine, so the urine protein test is most commonly used to screen for kidney disease. It's also used to monitor kidney function in kids already diagnosed with kidney disease or who are taking medications that can affect the kidneys.

Abnormal results also may point to diseases affecting other parts of the body. Other tests may be needed before a definite diagnosis can be made.

Preparation

Before the test, your child might need to temporarily stop taking specific drugs that could interfere with results. Be sure to discuss this with your doctor.

The Procedure

Collecting the specimen should only take a few minutes. Your child will be asked to urinate into a clean sample cup in the doctor's office. If your child isn't potty trained and can't urinate into a cup, a small catheter may need to be inserted into the bladder to obtain the urine specimen.

Alternatively, a urine collection bag with adhesive tape on one end might be used to collect a sample from an infant. You'll clean your baby's genital area and then arrange the bag around the urinary opening. Once the bag is in place, you'll secure it with the attached tape. You can then put a diaper on your baby. Remove the collection bag once your baby has urinated into it, usually within an hour. Deliver this specimen to the lab.

If you take the specimen at home, follow any storage and transportation instructions the lab gives you.

What to Expect

Because the test involves normal urination, there shouldn't be any discomfort as long as your child can provide a urine specimen.

Getting the Results

The results of the urine protein test should be available within a day. Your doctor will go over the results with you and explain what they mean. If the results are abnormal, further tests may be ordered.

Risks

No risks are associated with taking a urine protein test. Infants may occasionally experience skin irritation from the adhesive tape on the collection bag. If a catheter is used to obtain the urine, it may cause temporary discomfort. If you have any questions or concerns about this procedure, talk to your doctor.

Helping Your Child

The urine protein test is painless. Explaining how the test will be conducted and why it's being done can help ease any fear. Make sure your child understands that there should be no foreign matter, such as toilet paper or hair, in the sample.

If You Have Questions

If you have questions about the urine protein test, speak with your doctor.

Reviewed by: Yamini Durani, MD
Date reviewed: February 2012