Radionuclide cystogram

Definition

A radionuclide cystogram is a test (nuclear scan) using radioactive material (radioisotope) that is placed into the bladder. A scanner then detects radioactivity to check bladder and urinary tract functions.

How the test is performed

The specific procedure may vary slightly depending on the reason for the examination (reflux, distention, incomplete emptying, or others).

You will lie on the scanner table. After cleaning the urinary opening, a catheter will be placed into the bladder through the urethra. A solution containing the radioisotope will be instilled into the bladder until the bladder is full (or you indicate that the bladder feels full).

Depending on the suspected problem, the timing of scanning/imaging varies. The bladder may be scanned while full. You may be asked to urinate into a urinal, bedpan, or towels while being scanned.

To test for incomplete bladder emptying, images may be taken with the bladder full, then you will be allowed to get up and urinate into the toilet and return to the scanner. Images are taken immediately after emptying the bladder.

How to prepare for the test

No medication, fasting, or special diets are usually necessary.

A consent form will need to be signed. You will wear a hospital gown. Remove jewelry and metal objects before the scan.

How the test will feel

There may be some discomfort during insertion of the catheter. Catheterization and urination in public -- sometimes, when lying on the table -- may be difficult or embarrassing. You cannot feel the radioisotope or the scanning.

After the scan, there may be slight discomfort for 1 or 2 days when you urinate and the urine may be slightly pink. If discomfort persists, fever develops, or if the urine is bright red, notify the health care provider.

Why the test is performed

This test is performed to evaluate the filling and emptying of the bladder, and to evaluate for reflux of urine or obstruction to the flow of urine.

Normal Values

A normal value is no reflux or other abnormal urine flow, and no obstruction to the flow of urine occurs. The bladder empties completely.

What abnormal results mean

• Vesicoureteric reflux (backflow of urine) may be revealed when the bladder is full or during urination.
• Incomplete emptying may be the result of urethral obstruction, most commonly related to an enlarged prostate gland (men).
• The test may show abnormal bladder response to pressure, which could indicate a neurologic abnormality or other disorder.

What the risks are

Risks are the same as for x-rays (radiation) and catheterization of the bladder.

There is a small amount of radiation exposure with any nuclear scan (it comes from the radioisotope, not the scanner). The radiation is very mild, and virtually all radiation is gone in a short time. However, any radiation exposure is discouraged for women who are or might be pregnant.

Risks for catheterization include a risk for causing a urinary tract infection and the risk (rare) of damage to the urethra, bladder, or other nearby structures.

Special considerations

This test is very useful to provide information about how the bladder responds to pressure, without exposure to radiographic contrast materials.

Illustrations

Cystography

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