What is retrograde cystography?

Retrograde cystography is an imaging test that uses X-rays to see the bladder. X-rays are made of the bladder after it has been filled with a contrast dye. The dye lets the radiologist see your bladder and nearby tissues more clearly. Retrograde cystography can also be done using computerized tomography (CT), another type of imaging.

During retrograde cystography, dye is injected into the bladder. X-rays are taken of the bladder while it's filled with dye and again after the dye has drained. Retrograde cystography may show rupture of the bladder, as well as tumors, blood clots, or pouches in the wall of the bladder (diverticula).

Why might I need retrograde cystography?

Retrograde cystography may be done if you’ve had an abdominal injury to check whether the bladder has ruptured. Other conditions that may be checked by retrograde cystography include:

• Problems with nerve supply to the bladder
• Tumors
• Urine flows backward from the bladder into the ureter
• Recurring urinary tract infections (UTIs)
• Stones
• Abnormal connections between tissues (bladder fistulae)
• Foreign bodies
• Urine leakage from the bladder after bladder surgery

Your healthcare provider may have other reasons to recommend retrograde cystography.

What are the risks of retrograde cystography?

You may want to ask your healthcare provider about the amount of radiation used during the test. Also ask about the risks as they apply to you.

Consider writing down all X-rays you get, including past scans and X-rays for other health reasons. Show this list to your provider. The risks of radiation exposure may be tied to the number of X-rays you have and the X-ray treatments you have over time.

Tell your provider if:

• You are pregnant or think you may be. Radiation exposure during pregnancy may lead to birth defects.
• You are allergic to or sensitive to medicines, contrast dyes, local anesthesia, iodine, or latex
• You have kidney failure or other kidney problems

You are at risk for a bladder infection because a thin tube (catheter) is put into your bladder during the test. The catheter may also cause bleeding (hematuria).

You should not have retrograde cystography if you:

• Had recent bladder surgery
• Have a blockage of the urethra, or damage or tearing of the urethra
• Have a urinary tract infection

You may have other risks depending on your specific health condition. Talk with your provider about any concerns you have before the procedure.

How do I get ready for retrograde cystography?

• Your healthcare provider will explain the procedure to you. Ask him or her any questions you have about the procedure.
• You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
• Follow any directions you are given for not eating or drinking before the procedure.
• Tell your healthcare provider if you are pregnant or think you may be.
• Tell your healthcare provider if you've ever had a reaction to any contrast dye, or if you're allergic to iodine.
• Tell your healthcare provider if you're sensitive to or are allergic to any medicines, latex, tape, and anesthesia.
• Tell your healthcare provider of all prescription and over-the-counter medicines and herbal supplements that you're taking.
• Tell your healthcare provider if you have a history of bleeding disorders. Also tell your provider if you're taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. You may be told to stop these medicines before the procedure.
• You may be told to take a laxative the night before the procedure. Or, you may be given an enema or a laxative the morning of the procedure.
• Follow any other instructions your provider gives you to get ready.

What happens during retrograde cystography?

You may have a retrograde cystography as an outpatient or during a hospital stay. The way the test is done may vary depending on your condition and your healthcare provider's practices.

Generally, a retrograde cystography follows this process:

1. You'll need to remove any clothing, jewelry, or other objects that might interfere with the procedure.
2. You may need to change into a hospital gown.
3. You'll be asked to empty your bladder before the procedure.
4. You'll lie on your back on the X-ray table.
5. A catheter will be inserted into your bladder for injection of the contrast dye.
6. A kidney, ureters, and bladder (KUB) X-ray will be taken to check that the urinary system is visible. With males, a lead shield may be placed over the testes to protect them from the X-rays.
7. The healthcare provider will inject dye into the bladder through the catheter. After the dye has been injected, the provider will clamp the catheter tubing to stop the dye draining from the bladder.
8. X-rays will be taken while the dye is being injected and after. You may be asked to change position for other X-ray views of the urinary system.
9. The dye will be drained from the bladder, and then one or more X-rays will be made. If needed, air may be injected into the bladder before more X-rays are taken.
10. After all X-ray have been taken, the catheter will be removed.

What happens after retrograde cystography?

You don't need any special care after a retrograde cystography. You may go back to your usual diet and activities, unless your healthcare provider tells you otherwise.

You should drink extra fluids for a day or so after the procedure. This will help clear the dye from your system. It also helps prevent bladder infection.

You may have some mild pain when you urinate or see a pink tinge to your urine for a day or 2 after the procedure. This is normal after you’ve had a catheter.

Call your healthcare provider right away if any of these happen:

• Pain when you urinate gets worse or lasts longer than 2 days
• Fever or chills
• Pain in your belly (abdomen)
• Blood in the urine
• You have less urine than usual

Your healthcare provider may give you other instructions, depending on your situation.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• Who will do the test or procedure and what that person’s qualifications are
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• Who to call after the test or procedure if you have questions or problems
• How much will you have to pay for the test or procedure