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Subject: Re: VCUG
Forum: The Urology Forum
Topic Area: Urinary Tract Infections
Posted by HFHS M.D.-AK on July 31, 1998 at 16:27:32:
In Reply to: VCUG posted by Lori Hilliard on July 24, 1998 at 16:41:21:
My 7 year old daughter is scheduled for a VCUG this coming Thursday
. She has just been through an emotional time, as both of my
parents have died within the last six months and we've spent a lot of
time in hospitals. She's terrfied, even before dealing with the
fear and embarrassment that messing with her "privates" will cause.Any info about the procedure would be appreciated and any suggestions
on how I can prepare her would be great. Thanks.
lori
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Dear Lori,
Judging from the date of this question I may be too late to answer your questions such to prepare your daughter for this test, however, I will still attempt to provide you with some information such that you may better understand why this test and other similar tests need to be done. The VCUG is an X-ray test that takes pictures in a sequence. This enables doctors to evaluate how well the urinary tract is functioning and identify if a patient has reflux which I will discuss later. The V stands for voiding so the X-rays are taken while your daughter is urinating.
The topic area that this question is listed under is Urinary tract infections. I can only presume your daughter had a urinary tract infection and a VCUG is one of the cornerstones of this work-up. Unlike in adults when a urinary tract infection occurs in a child, the body is not fully developed. An infection in a developed kidney may still cause damage however it will have a significant reserve to function adequately. In a child, an early infection may lead to scarring and a significant reduction in a childs overall potential renal function. Your daughters doctors are trying to determine if she is at risk for upper urinary tract infections or kidney infections.(pyelonephritis) A VCUG is designed to examine the inside contours of the bladder and determine if there is any reflux up the two tubes that bring the urine down from the kidneys called the ureters. If some of the dye in the bladder goes backwards up the ureters, this is termed ureteral reflux. Reflux is graded into 5 stages depending on how severe or how much dye goes back into the kidney. A renal system that refluxes is a greater risk for upper tract infections and therefore at risk for significant renal scaring and damage.
Many urologists will recommend a period of prophylactic antibiotics in order to control future urinary tract infections. If a patient were to have severe reflux and breakthrough infections, this may be an indication for surgical intervention.
There is another similar test available to detect reflux. This study is called a nuclear cystogram. Some people advocate this study because there is less radiation exposure. However the exposure is so minimal from the VCUG, this point of view is not a determining factor to decide which study to perform. A VCUG will also give the doctor a visual picture of the outlines of a childs urinary tract where a nuclear cystogram will not give a very clear picture.
Other studies that may need to be done down the line include ultrasound looking for a dilated kidney and ureter and a renal scan to see how well the kidney functions.
Reflux in children if caught early care be corrected or managed successfully such that the kidneys may be protected. This is the main goal of this work-up.
This information is provided is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
HFHS M.D.-AK
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