Voiding cystourethrogram (VCUG) for girls

Your child is scheduled for a voiding cystourethrogram (VCUG) at Children's.

Date: ____________________________

Test time: ____________________________

Check-in time: ____________________________

___ Children's - Minneapolis
2525 Chicago Avenue South
Minneapolis, Minnesota 55404
612-813-8200

___ Children's - St. Paul
345 North Smith Avenue
St. Paul, Minnesota 55102
651-220-6147

___ Children's Minnetonka
6050 Clearwater Drive
Minnetonka, Minnesota 55343
952-930-8600

Please bring a list of your child's medicines and your insurance card with you. If you have questions about your insurance coverage for these services, or any special referral requirements, please contact your insurance company directly. They will advise you about your plan's coverage.

A parent or legal guardian must accompany children younger than 18 years old.

If your child is 10 years old or older she will need to have a pregnancy test done before we can begin this exam. Your child will be asked to give a urine sample and a quick pregnancy test will be done at that time by the technologist.

What is a VCUG?

This test determines how the urinary tract is working. The urinary tract includes:

• bladder (where urine is stored)
• ureters (tubes between the bladder and the kidneys)
• urethra (the tube from the bladder to the opening where urine comes out)
• kidneys (where urine is made)

How is the test done?

A technologist will take you and your child into an exam room. You will see a large table and a large camera connected to a monitor. Your child will be asked to put on a hospital gown and lie on the table. You will be given a lead apron to wear if you wish to stay with your child in the room. You may stand by her head to support and distract her.

An X-ray may be taken of your child's abdomen (belly, stomach). The radiologist or technologist will then ask your child to put her legs in a "butterfly" or "frog" position. The technologist will wash and dry the area between her legs to make sure it is very clean.

Next, the technologist will insert a catheter (soft, flexible tube) into your child's urethra. The catheter is about the size of a piece of cooked spaghetti, with a smooth, rounded end. A small piece of tape or a small balloon at the end of the catheter will be used to hold the catheter in place on her leg. Inserting the catheter may feel uncomfortable to your child, but this part of the test will be over quickly. Your child may feel that she needs to urinate while the tube is in, even though her bladder will be empty.

With your child lying under the large camera, contrast material (a clear liquid that makes it possible to view the bladder) will flow from a bottle through the catheter into her bladder. When the bladder fills, she will feel the urge to urinate. She will be asked to say when she feels that her bladder is very full. The radiologist will ask her to hold the liquid for a few seconds more while X-rays are taken. She may be asked to turn side to side for these X-rays.

Then the tape holding the catheter in place will be removed. Your child will be asked to urinate into towels while she is lying down. The catheter will come out while she urinates. It is important that she stays still while she urinates, since X-rays will be taken.

The radiologist will check the X-rays to make sure they are complete before you leave.

Can I be with my child during the test?

If not pregnant, you are welcome to stay with your child. The VCUG generally lasts about 30 minutes. If your doctor has ordered sedation for your child, plan on about 60 minutes. See the education sheet, "Nitrous oxide for sedation."

What should we do before the test?

Usually you can maintain your child's routine eating, sleeping, and medicine schedules before the test. There may be different instructions if your child will have sedation or more tests in radiology on the same day.

Read and discuss this information with your child. Answer as many questions as you can.

To learn more about preparing and helping your child cope with this test, call the child life department. Child life specialists are trained to help children understand and cope with medical procedures and can offer advice on how to talk with and support your children. There is no charge for child life.

Children's - Minneapolis: 612-813-6259
Children's - St. Paul: 651-220-6465
Children's Minntonka: 952-930-8773

How should I prepare my child?

Children are usually less afraid and feel more successful when they know what to expect and what is expected of them. You know your child best. The amount of detail you give will depend on your child's age and developmental level, reactions to previous health care experiences, and degree of anxiety about this test. Talking about it can help her be more comfortable during the test, which will make the procedure easier for both of you.

Most children benefit when you use simple words to explain:

• why the test is needed. For example, "This test will help us find out how your bladder and kidneys are working" or "This test will help us find out why you had a bladder/kidney infection."
• what parts of her body will be involved. For example, "Your kidneys and bladder are the parts of your body that make your pee/urine" (use the words familiar to your child).
• what she might see, hear, and feel—the camera, cool soap, touch to private parts, urge to urinate.
• where parents or other significant care providers will be during the test: "I/we will be with you the whole time."
• that it is okay for hospital staff to touch her body, including private parts, for this test.
• that we welcome questions at any time.

For many children, a big concern is whether or not the test will hurt. Assure her that although there may be some discomfort, it will only last a few moments. Remind her that the test is important because it helps find out how her body is working inside.

How can I support my child during this test?

Before the appointment, you and your child can:

• practice lying down and being "as still as a statue."
• practice relaxing. Imagine being in a favorite place or doing a favorite activity.
• pack comfort items, such as a stuffed toy or blanket, some familiar books or quiet toys, a pacifier for very young children. Older children and teens may want to bring an iPod or a hand-held video game.
• talk about how much she wants to know about the test while it's happening. Some children want to be told each step in advance and also while it's happening. Others do not want all the detail – they simply want to be distracted and supported. Be sure to share your child's wishes with the staff once you are here.

During the test

Research is clear that parents are most helpful to their children during stressful times when they offer distraction, not apologies.

• Use praise. Tell your child how well she's doing often during the test. Be specific to her behavior, such as "You're holding still. Good for you!" or "You're doing just what we asked you to do!"
• Talk about familiar, positive things – what your child likes, places she's enjoyed, activities you're planning as a family, fun times you've had, successes she's had.
• Imagine the places, things, or people you're talking about and describe them to your child, or have her describe them to you. Ask open-ended questions that engage her in conversation rather than those that require just a yes or no answer. For example, "Tell me what you'd like to do when we go to the pool" works better than, "We're going to have a great time when we go swimming, aren't we?"
• Sing songs together. Play games that require her to think, such as asking her to spell words from her spelling list, or add and subtract out loud. Ask a young child what animals live on a farm or in the zoo and the sounds they make, or to name all the people in her family or class, and so on.
• Read the books she packed, hold the toy so she can see and play with it, play "can you guess" and give clues about people/pets you know, things you see in the room.

What can we expect after the test?

There may be some temporary soreness where the catheter was and the urine may look slightly pink. Assure your child that these are normal and will go away soon. Sometimes a warm bath (plain water, no bubbles) can be comforting. Encourage your child to drink plenty of fluids. See the education sheet, "After a urinary catheter."

What else do we need to know?

You may pre-register online at www.childrensmn.org. Please do this before 3 p.m. the day before the test.

If you prefer, you can call the admitting office the day before the test is scheduled.

Children's - Minneapolis: 612-813-6231
Children's - St. Paul: 651-220-6878
Children's Minnetonka: 952-930-8600

Pregnant women cannot be in the exam room during the test. A family member or friend, age 18 or older, may stay with your child. Siblings may not be in the room during the test. Please have an adult stay with them in the waiting room, or sign them into the Sibling Play Area (if 2 years or older). Call to ask about hours:

Children's - Minneapolis, 2nd floor
612-813-7051
Children's - St. Paul, 1st floor
651-220-7150

Plan to allow extra time before the appointment, to check your children into the Sibling Play Area.

Questions?

This sheet is not specific to your child but provides general information. If you have questions or need more information about the test, call the radiology department at the site checked at the beginning of this sheet.

Children's Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404

Reviewed 10/2019

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