Urethrocystography: what it is, what it is for and how to prepare

Cyst urethrography is a diagnostic test indicated to evaluate the size and shape of the bladder and urethra, or identify blockage or narrowing of the urinary tract, to diagnose the causes of vesicoureteral reflux, which is the return of urine from the bladder to the kidneys. , which is more common in children, or even diagnose recurrent urinary infections in adults, for example.

This examination, also known as retrograde cystourethrography, is performed using an and bladder emptying.

Cyst urethrography can be performed free of charge by the SUS, as long as it has a medical indication, but it is also carried out in hospitals or private examination clinics, and the results must be analyzed by the general practitioner or urologist.

What is it for

Cyst urethrography is indicated to evaluate changes in the anatomy and functioning of the bladder and/or urethra, and diagnose diseases such as:

• Congenital malformations of the bladder or urethra;
• Vesicoureteral reflux;
• Recurrent urinary infections;
• Pyelonephritis;
• Obstruction of the urethra;
• Dilation of the kidneys, called hydronephrosis;
• Dilation of the ureter, called hydroureter;
• Urinary incontinence;
• Incomplete emptying of the bladder.

Furthermore, cystourethrography may be indicated to evaluate bladder injuries, such as bladder rupture after trauma or pelvic fracture, when there is the presence of blood in the urine.

How to prepare for cystourethrography

To perform cystourethrography, certain precautions must be taken, such as:

• Tell your doctor if you are allergic to iodine or any other type of radiological contrast, latex, medicines, such as penicillins, or foods, such as shellfish or seafood, before taking the exam;
• Tell if you are pregnant or suspected pregnancy, in the case of women;
• Tell your doctor if you use oral medicines for diabetessuch as metformin (Glucoformin or Glifage), before taking the exam;
• Inform your doctor about the use of anticoagulant medicationssuch as warfarin, heparin, rivaroxaban, acetylsalicylic acid or clopidogrel, as the doctor may advise you to stop these medications a few days before the exam;
• Bring a list of all medicationsvitamins and nutritional supplements that you take frequently;
• Inform if you have health problemssuch as kidney failure or other kidney problems, active urinary tract infection, severe dementia, or psychosis;
• Fastingapproximately 2 hours before the exam, as recommended by the doctor;
• Use laxatives and medicine for intestinal gas recommended by the doctor, to clean the intestine and eliminate gases, which can interfere with the X-ray image;
• Take your usual medicines normallywith little water, as per medical advice;
• Avoid taking medications that have not been prescribed by your doctorincluding home remedies and teas;
• Do not use earringswatch, or any other jewelry on the day of the exam.

Furthermore, in the case of children, a companion must be responsible for the child during the exam.

It is important to take all previously carried out tests, such as blood tests, urinary tract X-rays, computed tomography or cardiac magnetic resonance, for example.

How the exam is carried out

Cyst urethrography is performed in the hospital or in specialized clinics, by a urologist or radiologist by inserting a catheter through the urethra and into the bladder.

To perform cystourethrography, the doctor must follow some steps, such as:

1. Carrying out an X-ray simple before placing the catheter, to check the anatomy of the urethra and bladder and whether the intestinal preparation was done correctly, so as not to interfere with the results of the exam;
2. Cleaning the urethra region with an antiseptic;
3. Application of local anesthetic in the regionin order to reduce discomfort;
4. Introduction of a thin, flexible catheterthrough the urethral orifice until reaching the bladder;
5. Iodinated contrast injection directly through the catheter, which allows the bladder to be filled;
6. Performing multiple x-rays with the aim of observing the route that the contrast takes, whether there is any reflux or obstruction in the flow of urine, or rupture or perforation in the bladder;
7. Removal of the urethral catheterbeing asked to urinate;
8. Taking an X-ray after urinationto assess bladder emptying, this procedure being called post-void cystourethrography.

The images obtained by X-ray allow the doctor to observe the bladder and urethra in detail and in real time, making it possible to identify blockages, vesicoureteral reflux, anatomical changes or trauma to the urinary tract.

Cyst urethrography is a simple exam, which lasts about 30 minutes, and the doctor may also request that the person urinate while images of the bladder emptying are taken.

In the case of children, due to the discomfort of the procedure, sedation of the child may be necessary, as recommended by the doctor.

Urethrocystographic voiding

Voiding cystourethrography can be performed during the examination, and consists of evaluating the urethra and bladder at the time the person urinates, using radiological contrast, usually diatrizoic acid, and visualization by the doctor of the bladder emptying, through fluoroscopy. In real time.

Care after the exam

After cystourethrography, you should drink water or other liquids, except alcoholic beverages, and urinate frequently to eliminate the rest of the contrast.

Furthermore, the appearance of the urine must be observed in order to detect possible bleeding.