Urology Radiology Assessment Tools: Creating a Plan for Your Child's Care

The urinary system is made up of kidneys, ureters, bladder, and urethra. In general terms, the kidney filters out waste and extra fluid from the body. The ureters are the drainage tubes that move urine from the kidney to the bladder. The bladder is a hollow organ muscle that stores urine until it is emptied to pass outside of the body through the urethra. Various urology radiology tools are used to evaluate the urinary system and create a care plan for your child.

Renal Ultrasound

A renal ultrasound is the most used test to evaluate the kidneys and bladder. Images are produced by sound waves; there is no radiation involved. The painless test is completed in about 20-30 minutes and allows the medical provider to see the size of the kidneys, any abnormalities that may have been present since birth, swelling of the kidneys and/or ureters, damage to the kidneys, and kidney stones.

Voiding Cystourethrogram (VCUG)

A voiding cystourethrogram (VCUG) gives medical providers a better look at the kidneys, ureters, and bladder anatomy. This test involves placing a small catheter into the urethra (pee hole) into the bladder so that contrast dye can fill it. Then when the child voids (pees), it is determined if urine is going the wrong way back up to the kidneys, a condition called vesicoureteral reflux. The bladder shape can determine how the urine drains from the bladder. This test does use radiation; however, only the smallest necessary amount.

Urodynamic Testing

Urodynamic testing is used to check:

• how the bladder stores and empties urine
• how well the bladder is storing (holding) urine
• how well urine is emptied from the urethra.

A small catheter is placed in the urethra to slowly fill the bladder with salt water. Another small catheter in placed in the anus to measure pressures. There are 3 stickers that measure the pee muscles. These go on the knee and around the anus. The test does not use radiation and takes about an hour.

Videourodynamics

Videourodynamics uses the same equipment for a VCUG along with the computer for urodynamics. This test provides information about the kidneys, ureters, and measures bladder pressures and how much urine is left in the bladder with voiding (peeing). This test checks bladder anatomy and function at the same time and takes about an hour.

Other Tests

Testing such as a Lasix renal scan (Mag 3) or a DMSA renal kidney scan give more information about how the kidneys and ureters are functioning. A Mag 3 tells the medical provider if the kidney(s) is draining enough urine to the ureters and bladder and if there is a blockage. A DMSA gives information about how the kidneys are functioning. Both tests use a radioisotope tracer given through an IV to measure information. The tracer is removed from the body in the urine.  Each of these tests take longer than other kidney tests, varying from 2-4 hours.

Kidney lab tests are measured from blood. The most common tests are BUN, creatinine, and cystatin C. These labs give a value to decide how well the waste being eliminated in the blood.

A cystoscopy is a procedure that is done under general anesthesia to look at the inside of the bladder and urethra (pee hole).  A tube with a camera is used to look inside and at times help with placing medication into the bladder.

All of these tests are done to assist in making decisions that help ensure best outcomes for your child.