Is Cystogram Painful?

A cystogram is a diagnostic procedure that uses X-rays to examine the urinary bladder and if there are any leakages to it. Still X-ray images or fluoroscopy (similar to an X-ray movie) may be used. A cystogram may indicate how well the bladder empties during urination and whether any urine backs up into the kidneys. Doctors may recommend cystogram to access:

• The causes of hematuria (blood in the urine) 
• Recurring urinary tract infections
• The urinary system when there has been trauma to the bladder, or to assess the bladder for leaks after surgery
• Problems with bladder emptying and urinary incontinence
• Obstructions and strictures (narrowing) of the ureters or urethra
• Enlargement of the prostate gland
• Possible problems with the nerves leading to the bladder from the spine, before and/or after spinal surgery
• For a tear in the bladder wall following an accident

Depending on the circumstances, the procedure may take around one hour to complete:

• The patient will be asked to empty your bladder prior to the examination. Then they will be brought into the fluoroscopy room and asked to lie on the X-ray table. 
• The genital area will be cleaned and draped with sterile towels. 
• Some local anesthetic jelly will be used to make the examination more comfortable. 
• A thin hollow tube called a catheter will be inserted into your urethra (the opening through which urine exits your body). 
• The catheter will gently be advanced into the bladder. The contrast will then be put into the bladder via the catheter. As the contrast flows into your bladder, X-ray images will be taken. After the contrast has been introduced, the catheter tubing will be clamped to prevent drainage from the bladder.
• The patient may be repositioned so that the doctor or radiologist can see the area from several angles. 
• The X-ray equipment may also move around you in order to gain the best possible images. Once all the X-ray images have been taken, the catheter will be removed. Patients may then be asked to pass urine while further X-ray images are taken. 
• If a patient is asked to urinate and additional X-rays are taken while the patient empties the bladder, the test is no longer just a cystogram. It’s instead referred to as avoiding cystogram.
•  If the study is to check for a leak after surgery and a leak is found, the catheter will be left in place. If no leak is seen, the tube will be removed at the end of the study.

Post-procedure:

• There is no special type of care required after a cystogram. 
• Patients may resume the usual diet and activities unless contraindicated by the doctor. 
• Patients may need to drink additional fluids for a day or so after the procedure to help eliminate the contrast from the system and to help prevent infection of the bladder. 
• Patients may experience some mild pain with urination or notice a pink tinge to the urine for a day or two after the procedure.

Risks:

• There might be a very small risk of developing a urine infection. Patients may need to contact a doctor if they experience abdominal pain, shivers, or sweats, or if urine becomes discolored or smells offensive in the days after the procedure.
• There might be an allergic reaction to the contrast material.
• There might be excessive bleeding.
• Patients may feel discomfort during urination, which may last several hours.
• There might be an injury to the bladder or other organs.
• There is some exposure to radiation during the procedure because X-rays are used. However, as this is a low-dose examination, exposure to radiation is kept to a minimum. Generally, the amount of radiation you are exposed to during this procedure is equivalent to between a few days and a few years of exposure to natural radiation from the environment.