MCU is defined as a study of the lower urinary tract in which contrast is injected into the urinary bladder with the help of a catheter (long, narrow plastic tube) on an x-ray unit or fluoroscopic unit.
Avoiding cystogram demonstrate the lower urinary tract and helps to detect the existence of any vesicoureteral reflux, urinary bladder pathology and congenital or acquired of the bladder outflow tract.
Urograffin 60% used which needs to be diluted with normal saline in the ratio of 1:3.
The estimated volume of the contrast media to be given to the patient during the procedure is determined by age of the child except for children less than 1 year in age, for them, it is determined by the body weight.
For children less than one year
Weight (Kg) x 7 = capacity (ml)
For children less than two year
[2 x age (in years) + 2] x 30 = capacity (ml)
For children more than two year
[Age (in years)/2] x 30 = capacity (ml)
Scout film: The first image that is taken while performing the MCU and VCUG is the image of KUB that is called scout film. We evaluate the spine, pelvis, and soft tissues on the scout film.
After several seconds of the contrast media begins to flow, the image of minimally filled bladder is taken in Antero-posterior (AP) projection. During early filling a ureterocele or tumor can be detected and it may obscure as more contrast material enters into the bladder.
The bladder should appear smooth and regular in the last film, there should be no filling detects and the edges of the bladder image should be smooth.
The image taken during voiding may demonstrate the urethral strictures or obstructions. They will also give the details of the presence or absence of vesicoureteral reflux. Voiding film necessary because gives the determination of reflux because reflux may only happen with the pressure generated by voiding.
A post-voiding film may demonstrate the reflux or extravasation of urine from the bladder or urethra. A normal post-void film has no reflux and no residual urine.
No special aftercare is necessary for this procedure. However, patients should be warned that dysuria, may lead to retention urine, it is rarely experienced. In these types of cases, a simple analgesic may help and children can be helped by allowing them to micturate in a warm bath.