Urology Book

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Voiding Cystourethrogram

Aka: Voiding Cystourethrogram, Nuclear Cystogram, VCUG
  1. Types
    1. Standing Voiding Cystourethrogram (VCUG)
      1. Instill radiopaque contrast medium into Bladder
      2. Image Bladder and Kidneys while standing
      3. Image while Bladder fills and voids
    2. Nuclear Cystogram
      1. Instill radionuclide into Bladder
      2. Image Bladder and Kidney with gamma camera
      3. Less radiation and equivalent sensitivity to VCUG
      4. Less precise grading of reflux compared with VCUG
  2. Findings: Ureteral Reflux
    1. Grade I: Reflux into nondilated distal ureter
    2. Grade II: Reflux into upper collecting system
    3. Grade III: Reflux into dilated ureter
    4. Grade IV: Reflux into grossly dilated ureter
    5. Grade V: Massive Reflux, calyceal tortuosity

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