Preparing for Your Child's VCUG Exam
What is a VCUG?
A voiding cystourethrogram (VCUG for short) is a test done in the radiology department of the hospital. Special pictures called X-rays will be taken to help you and your doctor know how your child’s urinary system is working. The urinary system includes the bladder, kidneys and the tubes that connect them called the ureters.
We want this experience to be as physically and emotionally comfortable as possible. You may want to bring items that your child finds comforting, such as a special toy, teddy bear, doll or blanket that your child can hold during the VCUG. Deaconess also has portable DVD players, hand-held games and an iPad that we may provide for your child if necessary for distraction.
Stage 1: Getting Ready
What to Expect During the Procedure
Stage 2: Sedation
Once you are registered, a staff member will escort you to the next destination. You may have to go to the radiology department to get an ultrasound of your child’s kidney before being taken to the pediatric department for admission.
At the pediatric unit, a nurse will ask several questions about your child’s health, and you will be asked to sign some forms. The nurse will also assess your child (similar to how the nurse at the doctor’s office does before seeing the doctor). After the nurse is done, the pediatrician will speak with you and your child.
Once your child has been checked in to the pediatric department, the pediatrician will assess your child and determine the sedation medication to be given by the nurse. This medicine is a liquid that will be given by mouth to help your child relax and forget the procedure, but your child will be awake the whole time. Your child may experience some discomfort during catheter insertion, and they often are fearful, as they will not want someone they don’t know touching their private area and inserting the catheter.
Stage 3: Catheter Insertion
The sedation medication may take 20–30 minutes to begin working. Children react differently to the medication. Your child may act silly after being given the medication. Please help the pediatric staff ensure your child’s safety by watching your child closely, because they may be unsteady on their feet.
Your nurse will also apply some gel to your child’s private area when the sedation medication is given. The gel’s purpose is to numb the area to decrease pain during the catheter insertion. This gel will feel cold and wet but does not hurt. It will be necessary to remove your child’s pants and underwear. Your child may wear a hospital gown or their own shirt and be covered with a blanket for privacy.
Once your child is relaxed from the sedation medication, your nurse will escort you to our treatment room for the catheter insertion. Your child will lie down on a bed. You may stay with your child during the catheter insertion to help comfort him or her. This can be an emotional experience. Before the nurse can put in the catheter, girls are asked to place their legs in the “frog leg” position. Boys just need to lie flat on the bed.
The nurse will then clean the private area between your child’s legs with some orange or brown soapy liquid. It may feel cold and wet. This makes the area extra clean. After the nurse cleans this area, it’s important not to touch anything below the belly button until the end of the test.
The nurse will need to slide the catheter along the path (inside your child’s body) that urine takes from the bladder to the outside of the body. The catheter is like a spaghetti noodle. The opening where the nurse puts the catheter in is called the urethra. Sliding the catheter in may be uncomfortable. The nurse will help the tube go in easier by putting some very slippery gel on the tube. The sedation medication the nurse had your child swallow will help your child not remember this part of the day. It’s important that your child is as relaxed as possible.
Helping Your Child Relax: Practice relaxtion activities like blowing bubbles, reading and singing, prior to the procedure day to see which activity your child likes best. You might have your own ideas for helping your child through this procedure. Let us know your ideas. We will do whatever we can to help. We have movies, crafts, games and other activities to help your child. We realize this is new and different and may be a little scary for you, as well as your child. Let us know how you’re feeling.
Let your child know it’s ok to cry, but it’s important for parents to remain calm. The nurse may have to help hold your child still during the catheter insertion. We take care to tape the catheter to your child’s leg but, again, it’s important to keep hands away from area, as the tube can be pulled out easily.
Stage 4: Pictures
Once the catheter insertion is done, your nurse will take you back to your child’s room until the radiology department is ready. Your nurse will take you and your child down to the radiology department when it’s time for the test. You and your child will be taken into a room with a few big machines. These machines are just big cameras that take the special pictures! The cameras are connected to a TV screen so the doctor can see the pictures as they are being taken.
The technologist or radiology doctor will explain the procedure to you and your child. You may or may not be able to stay with your child when the pictures are taken, depending on how many people the doctor can have in the room. The technologist will let you know. Your nurse or technologist will be right there supporting your child every step of the way.
You might notice a tall pole with a bottle of clear liquid hanging at the top. The clear liquid is called contrast dye. This liquid will help the x-ray pictures be clear. It works kind of like invisible ink! The contrast dye will go from the bottle through the catheter and into your child’s bladder. This is not painful, but as this happens, your child may feel like they have to use the bathroom.
Stage 5: After the Test
Once the fluid is in your child’s bladder, the doctor will need to hold it there for a few seconds, and then the technologist will remove the catheter.
The doctor will ask your child to urinate on the table! Your child may have difficulty with this part if he or she is potty trained, because it is unnatural to urinate on a table and because it will feel as if they are wetting the bed. The technologist will make sure there are towels under your child to help absorb the liquid.
The doctor will take more pictures of your child’s bladder while they are urinating. This is how the doctor can see how your child’s bladder works and how urine flows from the ureters! The technologist may have to help your child lie still while the doctor is taking pictures so they do not come out blurry.
After all the pictures have been taken, your nurse will take you and your child back up to your child’s room to continue to watch him or her for the effects of the sedation medication. Your child will be able to put clothes back on. Your child may still be acting silly, but that’s ok! It will gradually wear off over the next few hours.
Some kids tell us it tingles or feels very warm the first few times they go to the bathroom after their VCUG. This is normal. Don’t worry; that feeling will go away soon. Your child’s nurse will give you discharge instructions and have you sign another paper before you leave.
That’s it! You did it! You will be able to get the results from your doctor during your follow-up visit at his or her office.