• Childhood Kidney Diseases
• /
• v.1 no.1
• /
• pp.97-100
• /
• 1997

Rupture or contrast extravasation of urinary bladder after voiding cystourethrography(VCUG) was a very rare complication which occurred in neurogenic or unused bladder. Only one case of bladder extravasation was reported in a girl with normal bladder function. Case: A 18 month-old boy presented with recurrent E. Coli urinary tract infection and was evaluated with isotope VCUG, which was failed to catheter insertion. Two days later, isotope VCUG was repeated with difficult catheter insertion. Two hours after isotope VCUG, gross hematuria and anuria developed, and abdominal distension was followed. Bladder rupture was diagnosed by abdominal sonography and computerized tomography. He was treated with simple closure and suprapubic catheter drainage.

• Clinical and Experimental Pediatrics
• /
• v.55 no.5
• /
• pp.181-184
• /
• 2012

Voiding cystourethrography (VCUG) is a commonly performed diagnostic procedure for the evaluation of vesicoureteral reflux with urinary tract infection or congenital renal diseases in children. The procedure is relatively simple and cost-effective, and complications are very rare. The iatrogenic complication of VCUG range from discomfort, urinary tract infection to bacteremia, as well as bladder rupture. Bladder rupture is a rare complication of VCUG, and only a few cases were reported. Bladder rupture among healthy children during VCUG is an especially uncommon event. Bladder rupture associated with VCUG is usually more common in chronically unused bladders like chronic renal failure. Presented is a case of bladder rupture that occurred during a VCUG in a healthy 9-month-old infant, due to instilled action of dye by high pressure. This injury completely healed after 7 days of operation, and it was confirmed with a postoperative cystography. The patient's bladder volume, underlying disease, velocity of the contrast media instilled, catheter size, and styles of instillation are important factors to prevent bladder rupture during VCUG. Management of bladder rupture should be individualized, but the majority of infants are treated with the operation. In conclusion, bladder rupture is a rare complication, however, delicate attention is needed in order to prevent more dire situations.

• The Journal of the Korea Contents Association
• /
• v.9 no.12
• /
• pp.385-390
• /
• 2009

The Pneumatic Reduction and VCUG (Voiding Cystourethrography) are commonly used in the paediatric age group. The procedures had a particularly long fluroscopic screening time, despite a successful outcome for paediatric patients. Pneumatic Reduction and VCUG almost invariably requires fluoroscopic guidance which does confer a radiation dose. This article contains suggestions on how the radiation dose to paediatric patients from Pneumatic Reduction and VCUG can be made "as low as reasonably achievable" (ALARA). The aim of our study was eliminated in spot image applying the FluoroGrab, which has function of capturing an image of interest area from the picturing while fluoroscopic procedures. FluoroGrab has clinical value equivalent to the spot image, and is applied to the most recent fluoroscopic procedures. The radiologist and the radiographers should consider new option for decreasing the radiation exposure delivered to paediatric patients by making equipment modifications to the fluoroscopy to optimize radiation exposure reduction techniques. Thus, we propose the FluoroGrab instead of spot exposure for the reduction of patient exposure dose in paediatric, and try to confirm the effect of the mitigating amount of radiation exposure to paediatric patients when pneumatic reduction and VCUG. Fluorograb is the safe and useful method that shows the equivalent level of accuracy to spot exposure, and to minimize the radiation load to paediatric patients are to be the substitute for the spot exposure for Pneumatic Reduction and VCUG.

• Proceedings of the Korea Contents Association Conference
• /
• 2009.05a
• /
• pp.1167-1172
• /
• 2009

The Pneumatic Reduction and VCUG (Voiding Cystourethrography) are commonly used in the paediatric age group. The procedures had a particularly long fluroscopic screening time, despite a successful outcome for paediatric patients. Pneumatic Reduction and VCUG almost invariably requires fluoroscopic guidance which does confer a radiation dose. This article contains suggestions on how the radiation dose to paediatric patients from Pneumatic Reduction and VCUG can be made "as low as reasonably achievable" (ALARA). The aim of our study was eliminated in spot image applying the FluoroGrab, which has function of capturing an image of interest area from the picturing while fluoroscopic procedures. FluoroGrab has clinical value equivalent to the spot image, and is applied to the most recent fluoroscopic procedures. The radiologist and the radiographers should consider new option for decreasing the radiation exposure delivered to paediatric patients by making equipment modifications to the fluoroscopy to optimize radiation exposure reduction techniques. Thus, we propose the FluoroGrab instead of spot exposure for the reduction of patient exposure dose in paediatric, and try to confirm the effect of the mitigating amount of radiation exposure to paediatric patients when pneumatic reduction and VCUG. Fluorograb is the safe and useful method that shows the equivalent level of accuracy to spot exposure, and to minimize the radiation load to paediatric patients are to be the substitute for the spot exposure for Pneumatic Reduction and VCUG.

• Childhood Kidney Diseases
• /
• v.12 no.2
• /
• pp.194-201
• /
• 2008

Purpose : Voiding cystourethrography(VCUG) is required to detect vesicoureteral reflux(VUR), which may manifest as urinary tract infection(UTI) in children. It is well known that VCUG can cause UTI(post-VCUG UTI). In this study, risk factors for post-VCUG UTI and the preventive effect of antibiotics against this complication of VCUG were explored. Methods : Medical records of 284 patients who underwent VCUG at our hospital in 2007 were reviewed retrospectively. The incidence of post-VCUG UTI and risk factors for post-VCUG UTI, and the impact of antibiotic use on prevention of post-VCUG UTI were evaluated. According to antibiotics usage, we divided the enrolled patients into 4 groups of noantibiotics group, prophylactic antibiotics group(prophylactic antibiotics having been used before), antibiotics-for-VCUG group(antibiotics added for VCUG) and antibiotics-for-treatment group(treatment dose of antibiotics). Results : Seven of 284 children(2.5%) developed UTI after they underwent VCUG. Highgrade(grade$\geq$III) VUR was the only statistically significant risk factor(odds ratio[OR] 6.266, P=0.026) for post-VCUG UTI, while sex, age, and other anomalies of urinary system were not significant. Five post-VCUG UTI cases belonged to prophylactic antibiotics group. Antibiotics use (three groups using antibiotics vs. no-antibiotics group) or addition of antibiotics for VCUG (antibiotics-for-VCUG vs. other groups) did not have any effect on prevention of post-VCUG UTI. Conclusion : The risk factor for post-VCUG UTI was high-grade VUR. Antibiotics use did not prevent post-VCUG UTI in this study.

• Clinical and Experimental Pediatrics
• /
• v.49 no.6
• /
• pp.653-658
• /
• 2006

Purpose : Because voiding cystourethrography(VCUG) is an invasive method, we studied whether VCUG could be postponed through evaluation of alternative non-invasive tests including renal ultrasonography and $^{99m}Tc$-DMSA renal scan. Methods : We reviewed the medical records of 175 patients initially diagnosed with febrile urinary tract infection during the one year period of 1999, and compared 3-tests : renal ultrasongraphy, $^{99m}Tc$-DMSA renal scan, and VCUG. Results : Renal ultrasonography didn't contribute to the prognostication of pyelonephritis(photopenic areas) or vesicoureteral reflux(VUR). Presentation of photopenic areas in $^{99m}Tc$-DMSA renal scan was related to VUR. If both findings of renal ultrasonography and $^{99m}Tc$-DMSA renal scans were normal, this condition was closely related to normal results in VCUG. And if both examinations were abnormal, the condition was closely related to VUR. But this state could not always guarantee the normal result from VCUG because of low sensitivity in finding VUR. Conclusion : In cases in which acute phyelonephritis is demonstrated by $^{99m}Tc$-DMSA renal scan, VCUG is required. In addition to this, if the conditions of hydronephrosis, vesicoureteral dilatation, increases of renal volume, and changes of echogenesity are shown by renal ultrasonography, VCUG should be performed. If a patient has difficulty undergoing VCUG, temporary postponement of VCUG can be taken into consideration, but only in cases where both examinations of renal ultrasonography and $^{99m}Tc$-DMSA renal scan are normal. Nevertheless, close observation is be advised even in this case.

• Childhood Kidney Diseases
• /
• v.5 no.2
• /
• pp.182-187
• /
• 2001

Purpose : To evaluate the clinical significance of antenatally detected mild fetal pelviectasia and the role of voiding cystourethrography (VCUG) Methods : From January 1999 to September 1999, 28 neonates (44 pelviectatic kidneys) with mild fetal pelviectasia (anteroposterial diameter <10 mm) were evaluated by postnatal renal sonography and voiding cystourethrography. Results : Among 44 mild pelviectatic kidneys, 29 ($65.9\%$) kidneys had no pelviectasia and 15 ($34.1\%$) kidneys had persistent mild pelviectasia on postnatal renal sonography. Four ($9.1\%$) kidneys of 3 males ($10.7\%$) without pelviectasia on postnatal renal sonography had vesicoureteral reflux (VUR) on voiding cystourethrography. Vesicoureteral reflux was not correlated with prenatal progression or regression of pelviectasia and was not correlated with postnatal pelviectasia. Conclusion : All neonate with mild fetal pelviectasia need to undergo voiding cystourethrography for early diagnosis of vesicoureteral reflux even though postnatal renal sonography shows no pelviectasia. (J Korean Soc Pediatr Nephrol 2001 ;5 : 182-87)

• Journal of the Korean Society of Radiology
• /
• v.81 no.1
• /
• pp.101-118
• /
• 2020

Voiding cystourethrography (VCUG) demonstrates the anatomy of the urinary system and is used to detect the presence/absence of vesicoureteral reflux. It is the most important modality for urological fluoroscopic examination in children. For improved patient care, it is important to understand and perform VCUG appropriately. Therefore, an in-depth review of VCUG protocols and techniques has been presented herein. In addition, tips, tricks, and pitfalls associated with the technique have also been addressed.

• Investigative Magnetic Resonance Imaging
• /
• v.4 no.2
• /
• pp.85-93
• /
• 2000

Purpose: To evaluate the availability of magnetic resonance (MRI voiding cystography for the diagnosis of vesicoureteral reflux (VUR) and to compare the sensitivity of MR voiding cystography (MRVC) with that of radiographic voiding cystourethrography (VCUG) in the detection of VUR. Material and Methods : MRVC was performed upon 20 children referred for investigation of VUR. Either coronal T1-weighted spin-echo or spoiled gradient-echo images were obtained before and after transurethral administration of a mixture of normal saline and gadopentetate dimeglumine, and immediately after voiding. The findings of MRVC were compared with those of VCUG performed within 6 months of MRVC. Results 1 VUR was detected in 23 ureterorenal units f16 VUR's by both methods, five VUR's by VCUG, and two VUR's by MRVC). The sensitivity of VCUG and MRVC in detecting VUR was 91.3% (21/23) and 78.3% (18/23), respectively. MRVC detected renal scarring in 15 out of 17 kidneys with scintigraphically detected renal scarring. Conclusion : Although MRVC is slightly less sensitive than VCUG in the detection of VUR, it can be used for the diagnosis of VUR and renal scarring simultaneouslyl and thus will reduce the radiation hazard.

• Childhood Kidney Diseases
• /
• v.11 no.1
• /
• pp.65-73
• /
• 2007

Purpose : Voiding cystourethrography(VCUG) is a commonly performed diagnostic procedure in children with urinary tract infections. Recently, with the widespread use of prenatal ultrasonography, VCUG is performed as part of the postnatal radiological evaluation of asymptomatic infants with prenatally detected hydronephrosis. The procedure is relatively simple but it involves discomfort and some complications. We studied post procedural symptoms and complications in children who underwent VCUG. Methods : This study reviewed 259 patients who underwent VCUG in our hospital between October 2005 and September 2006. We did a chart review and a telephone interview with the patients' parents about symptoms and complications associated with VCUG. Results : Among 269 children, 217 patients(80.7%) were under 2 years of age and 5 patients (1.9%) were over 8 years of age. Their mean age was $13.1{\pm}22.9$ months. After VCUG, dysuria was found in 49 patients presented with dysuria, and irritability in 36 patients with irritability. Other complications were hematuria, fever, frequency, bladder rupture and urinary tract infection. Mean symptoms duration was $1.4{\pm}0.7$ days. There was no significant relationship between prophylactic antibiotics use and complication rate associated with VCUG. Conclusion : Our study demonstrated that 32.7% of patients showed complications including bladder rupture and urinary tract infection after VCUG. We also found that prophylactic antibiotics use did not prevent urinary tract infection nor decrease the rate of complications associated with VCUG. Therefore, we suggest that the procedure must be done carefully and aseptically, and we should closely observe the children who undergo VCUG for development of possible complications.