X-ray imaging of the bladder and urethra with contrast: retrograde or suprapubic cystography, retrograde and voiding urethrocystography
Cystography and Retrograde Urethrocystography in Casablanca
Cystography examines the bladder; urethrocystography also examines the urethra, the channel through which urine leaves the body. An iodinated contrast agent fills the bladder through a thin catheter passed through the urethra or, depending on the indication, above the pubic bone. The exam shows the shape and outline of the bladder, how it empties, the appearance of the urethra and any backflow (reflux) of urine toward the kidneys. It is performed in children as well as adults, on prescription from a doctor, urologist or pediatrician.
Duration, report and equipment
Duration
Usually 20 to 30 minutes.
Report turnaround
Report within 24 hours. In an emergency, during opening hours, the report is handed over immediately.
Equipment
Carestream
Reading aid
The center uses Gleamer, artificial intelligence software that helps the radiologist read X-rays. Interpretation and the report are still done by the radiologist.
When is this exam needed?
- Repeated urinary tract infections in a child: looking for reflux toward the kidneys.
- Kidney dilation seen on ultrasound.
- Weak urine stream suggesting a narrowing of the urethra.
- Checking the bladder after surgery.
- Urine leakage or incomplete emptying of the bladder, depending on the urologist's assessment.
- Follow-up of known reflux, to check how it is changing.
How the exam is done
On arrival, the team checks the prescription, the urine test result (urine culture, ECBU) if one was requested, and that you have no fever or burning. You remove your clothes from the lower body. If the route above the pubic bone has been chosen, the radiologist explains this procedure to you before starting.
You lie on your back. After the area is disinfected, a thin catheter is inserted, which is briefly uncomfortable. The bladder is filled slowly until you feel a clear urge to urinate. You then urinate on the table, into a container: these images show the urethra and any reflux. Images are taken during filling, then while you urinate. The catheter is then removed and you can go home, remembering to drink plenty of fluids.
Preparation
- Bring the recent urine test (urine culture, ECBU) if one was requested.
- Tell the team about any known allergy to iodinated contrast agent.
- For a child, explain simply that a small catheter will be inserted and that they will need to urinate on the table, which is normal here.
- Plan to drink plenty of fluids in the hours after the exam.
Fasting
No fasting is required.
Contrast injection
The iodinated contrast agent goes directly into the bladder, not into a vein.
Contraindications and precautions
- Current urinary tract infection (fever, burning): the exam is usually postponed.
- Allergy to iodinated contrast agent or possible pregnancy: please tell us.
- Known narrowing of the urethra or recent surgery: let the team know before the catheter is inserted.
- Blood in the urine: please tell us before the exam.
Documents to bring
- Prescription from the doctor, urologist or pediatrician
- Recent urine test result (urine culture, ECBU) if requested
- Previous kidney and bladder ultrasounds
- Insurance or mutual insurance fund card
Price and insurance coverage
The center accepts coverage from insurance companies and the main mutual insurance funds. You submit the coverage request to your insurer or fund yourself. For AtlantaSanad and Sanlam, the center takes care of it.
No prices are shown on this site: Kenza gives you the exact price on WhatsApp, along with the coverage procedure for your situation.
Frequently asked questions
Will my child be put to sleep?
No, the exam is done while awake, without anesthesia. A parent can stay close by, wearing an apron, except in case of pregnancy.
Why urinate during the exam?
The urethra only really fills during urination, and reflux toward the kidneys often appears at that moment.
How do you feel after the exam?
A slight burning when urinating is possible on the same day: drink plenty of fluids. See a doctor if you have a fever, increasing pain or urinary burning that persists.
Can the iodinated contrast agent cause an allergy?
Very little of it passes into the blood, since it stays in the bladder. A reaction is rare, but tell us about any iodine allergy.
Is the exam painful?
Inserting the catheter is briefly uncomfortable, then the filling mainly causes a strong urge to urinate. If the discomfort becomes hard to bear, say so: the team adjusts the filling.
Why have a urine culture (ECBU) before the exam?
It checks that there is no urinary tract infection. Filling an infected bladder could make the infection worse, which is why the exam is postponed if there is fever or burning.