The radionuclide Cystogram allows the diagnosis and follow-up of vesicoureteral reflux. In general, the study is more sensitive than radiographic methods because of the high contrast between instilled radioactivity in the bladder and the lack of radioactivity outside of the bladder.
- Evaluation of vesicouretal reflux.
A Foley catheter should be placed with the patient lying on the nuclear medicine imaging table for patient comfort. Extension tubing (3-4 ft) is attached to the three-way stopcock and to a bag of sterile saline (250-1000 ml depending on patient’s age and size).
After introducing a small amount of sterile saline into the bladder to check for leakage, the radiopharmaceutical is introduced through the three-way stopcock and the bladder is continously filled with sterile saline. When filling the bladder, special attention is used in order to minimize patient discomfort.
Imaging is begun at the same time filling is begun and continued through complete filling. When the bladder has filled, the three-way stopcock is closed and an additional static image is taken. With the catheter in place the patient is instructed to void. Images are taken throughout the voiding and continued until the bladder appears to be emptied. Another additional static image of the bladder will be taken after it is emptied. At the end of the study the catheter will be removed.
- Approximately 1 hour
- Ensure patient is not pregnant or breast-feeding
- Need to know if there is an allergy to latex
- Obtain written informed consent. If the patient is a minor, obtain written consent from the parent or guardian.
- Cover the examination table with absorbent paper to avoid contamination with the radiopharmaceutical.
- Cleanse the urethral meatus and surrounding tissues with an aseptic solution. Anesthetic jelly (lidocaine) may be used for males.
- Insert age-appropriate Foley catheter and inflate the balloon.
- Connect the catheter to a 500 ml bottle of normal saline that is positioned not more than 100 cm above the table. Keep tubing clamped.
- Ensure the patient is not pregnant or breastfeeding.