Cystography - retrograde

Alternative names
Retrograde cystography

Retrograde cystography is a detailed X-ray examination of the bladder in which contrast dye is placed into the bladder through the urethra.

How the test is performed

You are positioned lying down on the table. A urinary catheter is inserted into your bladder after an anesthetic jelly has been applied. The dye flows through the catheter until your bladder is full (you inform the technician when your bladder feels full).

When the bladder is full, you are placed in different positions for various radiographs of the distended bladder. After the catheter is removed and you have been given the opportunity to urinate, one more X-ray is taken to see how well the bladder has emptied. The total test time is about 30 to 60 minutes.

How to prepare for the test
You must sign an informed consent form. You must void (empty) your bladder before the test. A history will be taken to determine if you may have an allergic reaction to the contrast dye or if there is a current infection that could make the catheter insertion difficult.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

How the test will feel
When the catheter is inserted, there may be some pressure along the urethra. When the dye first begins to enter the bladder, an urge to urinate occurs. The technologist will stop the flow when the pressure becomes uncomfortable. The urge to urinate will continue throughout the test.

After the test, the urethra may be tender during urination.

Why the test is performed

  • to examine the integrity of the bladder  
  • to verify the existence of:       o diverticula       o stones       o tumors       o vesicoureteric reflux       o bladder fistulae       o urinary tract infections       o rupture  
  • to determine the cause of recurring infections

Normal Values
The bladder should be normal in:

  • shape  
  • size  
  • texture  
  • contours  
  • capacity  
  • integrity  
  • urethrovesical angle

What abnormal results mean

  • diverticula  
  • lesions  
  • calculi (bladder stones)  
  • blood clots  
  • vesicoureteric reflux  
  • infection or inflammation

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

  • burning during urination (after the 1st day)  
  • chills  
  • fever  
  • increased heart rate  
  • increased breathing rate  
  • decreased blood pressure (hypotension)

Radiation exposure is similar to other X-rays. As with any radiation exposure, nursing or pregnant women are usually not recommended to 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 any more. More frequently, voiding cystourethrogram (VCUG) or cystoscopy are performed.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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