​RF VCUG

VCUG

** Determine whether you need to CYCLE

■   Cycling Criteria:
■    Patient is less than 1 year old
■    Patient had a fever with UTI (any age)
■    Patient with previous reflux (any age)

SUPPLIES:
■    Catheterization Kit
■    Straight Catheter (appropriate size)
■    Tape (to secure catheter)
■    Cystografin (Accudose) - dose according to patient age
■    Administration tubing for contrast
■    Chucks pads
■    Bed pan or Urinal

PROCEDURE:
   1. Involve Child Life (with appropriate ages)
   2. Explain exam to parents and child (Child Life will do this)
   3. Place towel and 2 chucks pads under patient (from armpits to mid-femur)
   4. Catheterize patient
       1. Sterilize, cleanse perennial area or penis (no Hibiclens)
       2. Use aseptic technique for catheter placement
       3. Use appropriate technique for genderUse appropriate technique for gender
       4. 8 Fr. straight cath, 6 Fr. or 5 Fr. catheter for newborns
       5. Tape catheter to groin or symphysis (single piece)
       6. Fix penis to right groin if necessary
   5. Contrast hung at 32 inches (20' with bladder reconstruction/augmentation)
       1. May inject 30-60 cc of air into bottle to relieve air block or improve flow, NOT with bladder reconstruction
   6. Fill bladder until the bottle's bubbles stop, or patient feels strong need to void
   7. Images to be obtained...collimate as tight as possible!! Image any urethral/ureteral symptoms, e.g., reflux, abnormal spray, difficulty catheterization, or anything abnormal. No voiding image is required if adequate image was obtained on prior study

Images:
■    KUB Scout under fluoro (EXPOSURE)
■    AP with 30 cc of contrast in bladder (IMAGE HOLD/SAVE)
■    AP with full bladder (IMAGE HOLD/SAVE)
■    Bilateral obliques for urethral insertion (IMAGE HOLD/SAVE)
■    Female - AP voiding urethra (IMAGE HOLD/SAVE) - don't wait longer than 10 min. If no voiding image is taken, change exam to Cystogram
■    Male - Oblique voiding urethra - one with catheter, one without catheter (EXPOSURE)
■    Call Radiologist for all voiding images - Refill bladder if pt voids sufficient time to evaluate urethra
■    Post Void (EXPOSURE)
■    Wash PerineumWash Perineum