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Radiographic Positioning: Radiographic Positioning of a Voiding Cystourethrogram


VOIDING CYSTOURETHROGRAM (VCU)

SUPPLIES:
Urinals - for males
Towels
Radiographi Contrast
I.V. Tubing for Contrast
Urethral Catheterization Tray
Urethral Catheter
Lidocaine Jelly - for males

ROUTINE VIEWS: K.U.B. (Scout)
Upright Abdomen Scout
K.U.B. (full bladder)
Lateral (full bladder)
Upright Lateral Standing (full bladder & catheter)
AP (voiding)
RPO (voiding)
LPO (voiding)
Lateral (voiding)
Post Void

Films may be done upright (or) supine, depending on patient condition and preference of Radiologist.

ALL FILMS ON A LARGE ENOUGH FILM TO INCLUDE URETHRA, BLADDER, AND BOTH KIDNEYS

K.U.B. (SCOUT)
1. 14 x 17 film
2. Patient is placed in supine position.
3. Film placed to include bottom of bladder as well as top of kidneys.
4. Bucky
5. 40" SID
6. Show film to Radiologist before proceeding. The Radiologist will fill the patient's bladder with contras under fluoroscopy.
AFTER FILLING PATIENT'S BLADDER WITH CONTRAST VIA CATHETER, THE FOLLOWING FILMS ARE TAKEN:

K.U.B. (FULL BLADDER)
Positioned same as Scout.

LATERAL (FULL BLADDER)
1. Patient placed in left lateral position.
2. Film positioned to include entire bladder.
3. Bucky
4. 40" FFD
*WHEN DOING FEMALE PATIENT TO RULE OUT CYSTOCELE, DO LATERAL STANDING TO INCLUDE PUBIS AND SACRUM ON FILM.

*REMOVE CATHETER BEFORE VOIDING FILMS.
ALWAYS ANGLE THE TABLE HEAD UP OR STAND THE PATIENT ERECT FOR VOIDING FILMS.

LATERAL VOIDING
1. 14 x 17 films
2. Patient placed in lateral position.
3. Film placed to include entire bladder and urethra.
4. Patient instructed to void while film taken.
5. Bucky
6. 40" SID
*MALES - DO LATERAL VOIDING FIRST.

*FEMALES WITH INCONTINENCE OF TO RULE OUT CYSTOCELE - DO ERECT LATERAL VOIDING TO INCLUDE PUBIS AND SACRUM ON FILM FOLLOWED BY BOTH OBLIQUES VOIDING.

RPO AND LPO VOIDING
1. 14 x 17 films
2. Patient placed in 30 degree posterior oblique position.
3. Film placed to include entire bladder and urethra.
4. Patient instructed to void while film is taken.
5. Bucky
6. 40" SID
*FEMALES WITH UTI OR RULE OUT REFLUX - DO BOTH OBLIQUES VOIDING FIRST FOLLOWED BY LATERAL VOIDING.

POST VOID
Positioned same as K.U.B.

*FILM SIZE AND VIEWS MAY VARY DEPENDING ON RADIOLOGIST.

BLADDER VOLUME: < 1 year - weight in Kg x 7cc/Kg
> 1 year - (age in year) + 2 x 30cc

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X-ray Positioning Guide