Radionuclide cystogram

Alternative names
Bladder scan

Definition
A Radionuclide cystogram is a test (nuclear scan) using radioactive material (radioisotope) that is placed into the bladder. A scanner then detects radioactivity to evaluate bladder and urinary tract functions.

How the test is performed

The specific procedure may vary slightly depending on the reason for the examination (reflux, distention, incomplete emptying, etc.)

You are asked to lie on the scanner table. After cleaning the urinary opening, a catheter is placed into the bladder via the urethra. A solution containing the radioisotope is instilled into the bladder until the bladder is full (or you indicate that the bladder feels full).

Depending on the suspected problem, the timing of scanning/imaging varies. The bladder may be scanned while full. You may be asked to urinate while being scanned (into a urinal, bedpan, or towels).

To test for incomplete bladder emptying, images may be taken with the bladder full, then the person is allowed to get up and urinate into the toilet, return to the scanner, and images are taken immediately after emptying the bladder.

How to prepare for the test
No medication, fasting, or special diets are usually necessary.

A consent form will need to be signed. You will wear a hospital gown. Remove jewelry and metal objects before the scan.

How the test will feel
There may be some discomfort during insertion of the catheter. Catheterization and urination in public (and sometimes, when lying on the table) may be difficult or embarrassing. You cannot feel the radioisotope or the scanning.

After the scan, there may be slight discomfort for 1 or 2 days when urinating and the urine may be slightly pink. If discomfort persists, fever develops, or if the urine is bright red, notify the health care provider.

Why the test is performed
This test is performed to evaluate the filling and emptying of the bladder, and to evaluate for reflux of urine or obstruction to the flow of urine.

Normal Values
A normal value is no reflux or other abnormal urine flow, and no obstruction to the flow of urine occurs. The bladder empties completely.

What abnormal results mean

     
  • Vesicoureteric reflux (backflow of urine) may be revealed when the bladder is full or during urination.  
  • Incomplete emptying may be the result of urethral obstruction, most commonly related to an enlarged prostate gland (men).  
  • The test may show abnormal bladder response to pressure, which could indicate a neurologic abnormality or other disorder.

Additional conditions under which the test may be performed:

     
  • Renal artery stenosis

What the risks are
Risks are essentially the same as for X-rays (radiation) and catheterization of the bladder.

There is a small amount of radiation exposure with any nuclear scan (it comes from the radioisotope, not the scanner). The radiation is very mild, and virtually all radiation is gone in a short time. However, any radiation exposure is discouraged for women who are (or might be) pregnant.

Risks for catheterization include a risk for causing a urinary tract infection and the risk (rare, but may occur) of damage to the urethra, bladder, or other nearby structures.

Special considerations
This test is very useful to provide information about how the bladder responds to pressure, without exposure to radiographic contrast materials.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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