From the Guidelines
A cystogram, also known as cystography, is a diagnostic imaging procedure that examines the urinary bladder, where a contrast dye is introduced into the bladder through a catheter inserted through the urethra, and then X-ray images are taken to visualize the bladder's structure and function. This procedure is essential in identifying abnormalities such as bladder tears, fistulas, vesicoureteral reflux, or structural problems. According to the guidelines provided by the World Journal of Emergency Surgery 1, retrograde cystography represents the diagnostic procedure of choice in bladder injuries. The procedure typically involves introducing a contrast dye into the bladder through a catheter, and then X-ray images are taken to visualize the bladder's structure and function.
Some key points to consider when performing a cystogram include:
- The procedure helps healthcare providers identify abnormalities such as bladder tears, fistulas, or structural problems.
- There are variations including static cystograms, which take still images of the filled bladder, and voiding cystourethrography (VCUG), which captures images during urination to assess bladder emptying and detect reflux.
- Patients should expect some discomfort during catheter insertion and may feel a sensation of fullness when the bladder is filled with contrast.
- The procedure typically takes 30-45 minutes, and patients can usually resume normal activities afterward.
- Cystograms are valuable because they provide detailed information about bladder anatomy and function that other tests cannot easily detect, helping guide treatment decisions for urinary tract conditions, as stated in the European Urology guidelines 1.
It's worth noting that the European Association of Urology guidelines office recommends cystoscopy as the cornerstone diagnostic tool to inspect the entire bladder for malignancy or other abnormalities in case of haematuria 1. However, when it comes to bladder injuries, retrograde cystography is the preferred diagnostic procedure, as stated in the World Journal of Emergency Surgery guidelines 1.
From the Research
Definition of Cystogram (Cystography)
A cystogram, also known as cystography, is a medical imaging procedure used to visualize the urinary bladder and its surrounding structures.
Types of Cystography
- Computed Tomography (CT) cystography: This type of cystography uses CT scans to provide detailed images of the bladder and its surrounding structures 2, 3, 4.
- Conventional radiographic cystography: This type of cystography uses X-rays to visualize the bladder and is considered the reference standard in detecting bladder injuries 3.
- Traditional cystogram: This type of cystography is used to confirm bladder injuries when CT cystography results are negative but there is a strong suspicion of injury 4.
Uses of Cystography
- Diagnosis and management of bladder fistulae 2.
- Evaluation of bladder injuries 3, 4.
- Diagnosis and management of interstitial cystitis/bladder pain syndrome (IC/BPS) 5, 6.
- Visualization of bladder diverticula and detection of leaks 4.
Key Findings
- CT cystography has become the initial imaging method of choice in the acute setting for suspected bladder injuries 3.
- Conventional cystography is still considered the reference standard in detecting bladder injuries 3.
- Traditional cystogram should be considered in cases with a negative CT cystogram and a strong suspicion of bladder injury 4.