BVCUG

Yulian Salis Patriawan

Definition

Also Known as Retrograde Urethrogram and

Voiding Cystourethrogram (RUG VCUG)
One Radiographic technique using positive contrast
media that is inserted to Bladder and urethra to
show how long the stricture of the urethra.
Imaging modality of choice for imaging the urethra
INDICATION CONTRA INDICATION

Urethral Stricture Untreated UTI

Urinary Retention Hypersensitivity to contrast media

Patient Preparation
Communication, Information and Education to the
patient and Family about the examination.
Informed Consent is a must.
Tools
X-Ray
Cassete and Film
Contrast ( Non Ionic )
Aquabides
Spuit
Hand Scoen
Alcohol Pads
Canule
1. Cystography
VCUG Provide excellent assesment of the posterior
urethra
Bladder neck and prostatic urethra are distended
during VCUG
Can Allow for better proximal asssesment of an
obliterated or near obliterated stricture
Can be administered following intravenous contrast
or simply by suprapubic catheter
 Contrast media (water soluble non ionic) is diluted
with aquades (1:4) 200 cc.
Position : Oblique
Oblique :
Object Position : Right Rotation (45 degree)
Light Projection : Vertical
Right Posterior Oblique
2. Urethrography
External meatus is prepared in standard sterile
fashion
Using 8 Fr Folley catheter ( should be flushed to
eleminate the introduction of air buble)
Oblique :
Object Position : Supine 45 degree oblique position
(leg abducted and knee flexed), Penis shuld be placed
laterally over the proximal thight with moderate
traction
Light Projection : Vertical
 If the patient is not positioned suficiently oblique,
the bulbous urethra will appear foreshortened
The 20 30 cc of 50 % iodinated contrast material
is injected under fluoroscopic guidance
The most appropriate way to evaluate anterior
urethra
Right Posterior Oblique
THANK YOU
Refference
1. Maciejewski; Rourke. Imaging of Urethral
Stricture Disease. 2015.
2. T.M. Walshe., C. Donagh. Urethrography :
Technique, Anatomy and Pathology. 2011.
Eurpoean Society of Radiology.