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Retrograde cystography

Definition

Retrograde cystography is a detailed x-ray examination of the bladder in which contrast dye is placed into the bladder through the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body.

Alternative Names

Cystography - retrograde; Cystogram

How the test is performed

You lie on the table. A numbing medicine is applied to the opening to your urethra, and a flexible tube (catheter) is inserted through your urethra into the bladder. Contrast dye flows through the tube until your bladder is full or you tell the technician that your bladder feels full.

When the bladder is full, you are placed in different positions so that different x-rays can be taken. A final x-ray is taken once the catheter is removed and you have emptied your bladder. This reveals how well your bladder empties.

The total test takes about 30 - 60 minutes.

How to prepare for the test

You must sign an informed consent form. You must empty your bladder before the test. You will be asked questions to determine if you may have an allergic reaction to the contrast dye, or if you have a current infection that could make inserting the catheter difficult.

How the test will feel

You may feel some pressure when the catheter is inserted. You will feel an urge to urinate when the contrast dye enters the bladder. The person performing the test will stop the flow when the pressure becomes uncomfortable. The urge to urinate will continue throughout the test.

After the test, the area where the catheter was placed may feel sore when you urinate.

Why the test is performed

Your doctor may order this test to:

• Examine the bladder for problems such as holes or tears
• Determine if you have:
  • Abnormal connections between bladder tissue (bladder fistulae)
  • Bladder stones
  • Diverticula
  • Tumor of the bladder
  • Urinary tract infection
  • Vesicoureteric reflux
• Learn why you keep having repeated bladder infections

Normal Values

The bladder appears normal.

What abnormal results mean

• Bladder stones
• Blood clots
• Diverticula
• Infection or inflammation
• Lesions
• Vesicoureteric reflux

What the risks are

There is some risk of infection from the catheter. Symptoms may include:

• Burning during urination (after the first day)
• Chills
• Decreased blood pressure (hypotension)
• Fever
• Increased heart rate
• Increased breathing rate

The amount of radiation exposure is similar to that of other x-rays. As with any radiation exposure, nursing or pregnant women should not usually have this test, unless it is determined that the benefits outweigh the risks.

Special considerations

In males, testicles are shielded from the x-rays.

This test is not performed very often, but is usually combined with CT Scan imaging for better resolution. Voiding cystourethrogram (VCUG) or cystoscopy is more frequently used.

References

Bhayani SB, Siegel CL. Urinary tract imaging: Basic principles. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 4.