1. CYSTOGRAMS, LOOPOGRAMS VCUGs & Urethrograms

2. Cystograms
Purpose: evaluation of the anatomy and physiology to the urinary bladder
Preparation:
1) explain the procedure to the patient
2) informed consent is required for catheterization of pediatric patients
3) have the patient empty his/her bladder

3. Supplies Sterile, disposable catheterization set
Contrast media: ionic contrast
Fluid administration set
Variety of straight and Foley catheters in varying sizes (#14 adults, #8-10 child)
(sometimes a small infant feeding tube for infants and toddlers)

4. Procedure Call nursing to perform catheterization
Take preliminary KUB scout
Set room up for fluoro
Measure any residual urine once catheter has been placed
Connect contrast media to catheter via catheter tubing set
Radiologist will begin to fill bladder w/ gravity flow

5. Overhead images AP
RPO
LPO

6. AP

7. RPO/LPO

8. Cystograms vs. VCUG
Cystogram: looking at the bladder only. The physician is not concerned about urethra, nor ureters!
VCUG: looking at the bladder, urethra & ureters. This exam is an extension of a cystogram in that we take voiding imaging to see if the contrast is refluxing up into the ureters.

9. VCUG
Same as the cystogram except overhead images will be taken on a 14x17 image size to include the kidneys, ureters & bladder. Usually done upright.

10. Procedure Preliminary KUB
Inflate balloon on Foley and press against the stoma. Do not inflate the balloon in the stoma!
Radiologist will inject contrast via the catheter into the stoma.
Once the procedure is completed help patient replace his/her stoma pouch.

11. Overhead Images AP RPO LPO
(Full 14x17 field size to include kidneys, ureters & bladder)

12. Retrograde Urethrograms
Purpose: For evaluation of urethral patency
Take preliminary image: RPO, center over the symphysis pubis and penis (70kVp), 10 x 12 F.S.
Possible overheads:
RPO

13. Overhead (male)

14. Overhead (female vcug)

15. Ileo Loopogram
Purpose: Evaluation of the anatomy of the post ileo-loop (ileo conduit)

16. Supplies 14, 16, or 18 French Foley catheters— with large balloon
50cc Cath tip syringe for contrast media
Hemostat
Sterile gloves
Sterile 4 x 4’s
20cc syringe to inflate the retention balloon
on the Foley
50cc’s of contrast media
Duraprep

17. Single-shot IVU Patient is pregnant
Same setup and consent as the standard IVU
Differences:
No preliminary KUB
15 minute KUB & show to the radiologist
No other images will be taken unless absolutely necessary and ordered by the radiologist!