What is a Cystourethrogram?

A cystourethrogram is a medical imaging test which uses X-rays to examine the lower urinary tract and bladder. Cystourethrography is performed while the bladder is full. In a similar test called voiding cystourethrography, the test is performed while the patient is urinating.

The cystourethrogram is commonly used to diagnose disorders of the bladder or urethra. People who are affected by chronic or repeat episodes of urinary tract infection, who suffer from stress incontinence or who have other urinary tract symptoms might undergo this test to determine the cause of the problem. In addition, this test can be used to diagnose a pediatric ureter abnormality called vesicoureteral reflux.

Prior to undergoing a cystourethrogram, a patient should inform his or her doctor about medications being taken and any allergies he or she has. A woman who wears an intrauterine device, or who is pregnant or suspects she might be pregnant, should ensure that her doctor is aware of this information. Informing a doctor about pregnancy is particularly important because X-ray exposure is potentially harmful to a developing fetus. Clearer X-ray images can be obtained when the intestines are empty, so patients might be asked not to eat for several hours before the test.

Cystourethrography involves a technique called fluoroscopy, which helps create more accurate and detailed X-ray images. This is necessary because X-ray alone cannot generate detailed images of the bladder and ureters. To improve the contrast of X-ray images, a person who is about to undergo a cystourethrogram is catheterized, and dye is injected into the bladder through the catheter. X-rays are taken after the bladder is full.

During the cystourethrogram, the patient lies on an X-ray table. The genital area is cleaned, and then the urethra is catheterized for the dye injection. Once this has been completed, X-rays are taken while the patient is lying down. Further X-rays are taken with the patient sitting up. Finally, the catheter is removed, and X-rays are taken while the patient urinates. In some cases the patient might be asked to change positions during urination; he or she must stop urinating, then move, and then urinate again.

The procedure ends when the patient’s bladder is empty. While cystourethrography is not painful, and there are few risks or problems involved, many people find it difficult to urinate because X-ray technicians are present during the procedure. In addition there might be some discomfort involved during catheter insertion.

After the procedure is over, it is normal to feel some discomfort when urinating during the next day or two. This is because of the presence of dye in the bladder and can be eased by drinking plenty of water to help flush the remaining dye out of the bladder. Increasing fluid intake also helps reduce the likelihood of a urinary infection, which can occur as a result of catheterization.

A small amount of blood in the urine is normal for one to two days after a cystourethrogram but might be an indication of a bladder injury if the presence of blood persists past the second day. Other symptoms to watch for include lower belly pain or indications of a urinary tract infection such as painful or burning urination, cloudy or foul-smelling urine, back pain, fever or chills. Anyone experiencing these symptoms should talk with or visit his or her doctor as soon as possible.