Cystourethrogram

Why It Is Done

A cystourethrogram is done to:

• Find the cause of repeated urinary tract infections.
• Look for injuries to the bladder or urethra.
• Find the cause of urinary incontinence.
• Check for structural problems of the bladder and urethra.
• Look for enlargement (hypertrophy) of the prostate or narrowing (stricture) of the urethra in men.
• Find out if urine is flowing the wrong way, from the bladder back toward the kidneys (vesicoureteral reflux).
• Look more carefully at abnormalities first found by intravenous pyelography.

How To Prepare

Tell your doctor if:

• You are or might be pregnant.
• You have symptoms of a urinary tract infection, such as pain or burning when you urinate.
• You are allergic to the iodine dye used in the contrast material or any other substance that contains iodine. Also tell your doctor if you are allergic to any medicines or have ever had a serious allergic reaction (anaphylaxis), such as after being stung by a bee or from eating shellfish.
• Within the past 4 days, you have had an X-ray test using barium contrast material, such as a barium enema, or have taken a medicine (such as Pepto-Bismol) that contains bismuth. Barium and bismuth can interfere with test results.
• You have an intrauterine device (IUD) in place.

This test is often done in children to see if they may have an abnormal backflow of urine (vesicoureteral reflux). Prepare your child for exams and tests that are needed by explaining them in a simple way. Use positive words as much as possible. Doing so will help your child understand what to expect and can help reduce fears.

You may be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).

How It Is Done

A cystourethrogram is done by a urologist or a radiologist. The doctor may be assisted by an X-ray technologist. You usually will not have to be admitted to the hospital.

You will need to take off all or most of your clothes, and you will be given a cloth or paper covering to use during the test. You will be asked to urinate just before the test begins.

You will be asked to lie on your back on an X-ray table. Your genital area will be cleaned and draped with sterile towels. Men may be given a lead shield that covers their genitals to protect them from radiation. But women's ovaries cannot be shielded without blocking the view of the bladder.

A catheter will be placed through your urethra and into your bladder. Contrast material will then slowly be injected through the catheter until your bladder is full.

X-rays will be taken when you are standing up and sitting and lying down. The catheter is removed and more X-rays will be taken while you are urinating. You may be asked to stop urinating, change positions, and begin urinating again. If you are unable to urinate in one position, you may be asked to try it from another position.

This test usually takes 30 to 45 minutes.

How It Feels

You will feel no discomfort from the X-rays. The X-ray table may feel hard and the room may be cool. You may find that the positions you need to hold are uncomfortable or painful.

You will feel a strong urge to urinate at times during the test. You may also find it somewhat uncomfortable when the catheter is inserted and left in place. You will have a feeling of fullness in your bladder and an urge to urinate when the contrast material is injected. You may be sore afterward. If so, soaking in a warm tub bath may help.

You may feel embarrassed at having to urinate in front of other people. This procedure is quite routine for the X-ray staff. If you find yourself feeling embarrassed, take deep, slow breaths and try to relax.

You may feel burning when you urinate.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

• Having barium (from a previous barium enema test), gas, or stool in the bowel.
• Being unable to urinate on command.
• Pain caused by having the catheter in the urethra. This may also cause problems with your urinary stream. You may have a muscle spasm or not be able to fully relax the muscles that control your bladder.

A cystourethrogram is not usually done during pregnancy because the X-rays could harm an unborn baby.

What To Think About

Other tests that use X-rays and contrast material to look for problems in the kidney, bladder, and urethra include:

• Retrograde urethrogram. This test is sometimes used to check for problems with a man's urethra. A small quantity of contrast material is injected into the urethra through a catheter. X-rays are then taken. This test can help find tears, scar tissue, prostate narrowing, tumors, or malformations of the urethra.
• Whitaker test. Also called a pressure/flow study, this test combines X-rays with measurements of pressure and flow in the kidneys and ureters. It is used to find the cause of blockage of the kidneys.
• Intravenous pyelogram (IVP) IVP is commonly done to diagnose certain diseases of the urinary tract (such as kidney stones, tumors, or infection) and detect abnormalities of the urinary tract that were present from birth (congenital). It can show the size, shape, and position of the kidneys, the bladder, the ureters, and the urethra, and it can evaluate the collecting system inside the kidneys. To learn more, see the topic Intravenous Pyelogram (IVP).