Micturition Cystourethrography

Micturition cystourethrography (MZU; synonym: micturition cyst urethrography, MCU) refers to a urologic examination method in which the urinary bladder and urethra are imaged before and during micturition (urination) using contrast medium as part of an X-ray examination.

Indications (areas of application)

  • Malformations/changes of the urinary bladder and/or urethra, such as urethral stenosis (narrowing of the urethra) or urethral valves (valves in the urethral area)
  • Suspected vesicoureteral reflux – reflux of urine from the bladder via the ureters (Hanrleiter) into the renal pelvis.
  • Urinary tract infection – with the help of micturition cystourethrography and retrograde urethrography, it is possible to detect a urinary tract infection associated with micturition disorders. In such a case, the procedure is a method of confirming the diagnosis.
  • Vesicoureteral reflux (synonyms: vesicoureteral reflux, vesicouretero-renal reflux, VRR, VUR, English : vesicorenal reflux) – unphysiological reflux of urine from the bladder via the ureters (ureters) into the renal pelvis; in the case of a urinary tract infection, there is thus the possibility that infected urine runs back into the ureters into the renal pelvis. Micturition cystourethrography can be used to check whether urine is flowing back into the ureters both at rest and during micturition. The procedure used is to assess the risk of inflammation of the kidney due to reflux.

Contraindications

Allergy to contrast media – if an allergy is present, micturition cystourethrography should not be performed under any circumstances because of the risk of allergic shock.

The procedure

With the help of micturition cystourethrography (synonym: micturition cyst urethrography, MCU), it is possible to recreate the physiological process of micturition and thus detect possible strictures or other pathological changes. At the beginning of the procedure, a transurethral (passing through the urethra) filling of the urinary bladder with contrast medium is performed. The use of the contrast medium is intended to facilitate the evaluation of the urinary tract and thus represents an important component of the X-ray examination. If the micturition cystourethrogram is combined with a simultaneous recording method, a precise assessment of pathological processes in the lower genitourinary tract can be achieved, which also serves as the gold standard (method of first choice) in diagnostics. Simultaneous recording as video is also called videourodynamics. Although the method is used relatively often for pathological changes in the urethra, the examinations must nevertheless be repeated several times in order to obtain therapeutically usable results. The micturition cystourethrogram is usually performed in a sitting body position. However, the body position can be varied depending on the problem. In order to obtain an overview of the bladder and urethra (urethral tube), the shape, position and, moreover, the function are observed by taking X-rays already during the filling of the bladder. Only when the bladder is completely filled and the micturition phase can take place, the micturition is examined with the help of various X-rays. By using different perspectives, a determination of the bladder function and a complete visualization of the bladder neck and the posterior urethra are possible. The closer the measurement method depicts the physiological micturition process, the better the results of the diagnostic procedure will be.

Possible complications