CYSTOGRAM

The term cystogram refers to a radiographic examination of the bladder and the urethra; the term cystogram refers to a conventional radiographic examination of the bladder with contrast medium instilled through a urethral catheter. Cystogram allows the evaluation of both anatomic defects and functional anomalies. Cystogram is indicated for evaluation of bladder lesions (eg, diverticula, foreign bodies, or fistulas), rupture, or leakage. Indications for imaging in blunt trauma include gross hematuria or nonacetabular pelvic fracture with significant microscopic hematuria (>25-30 red blood cells [RBCs] per high-power field [HPF]).[1] Contraindications for cystogram include the following : Active clinical UTI, Pregnancy, Allergy or sensitivity to contrast medium. Equipment used for cystogram includes the following: Sterile urethral catheterization kit with tubing, Urethral catheter, Sterile gloves, Surgical tape (for securing catheter in position), Intravenous (IV) pole, Fluoroscope or image recording setup, Contrast medium For voiding cystourethrography (VCUG), this should ideally be warmed to body temperature; temperature receptors in the bladder mucosa can mediate an increase in detrusor tone in young children[2] , Protective shielding equipment (eg, lead aprons and thyroid shields) for staff and caregivers in the room.

Patient Preparation : 1. Anesthesia A systematic review found that midazolam (0.5-0.6 mg/kg orally 30-45 minutes before the procedure or 0.2 mg/kg intranasally before the procedure) was safe and effective in reducing distress and did not interfere with voiding dynamics.[3] Nonpharmacologic methods, including patient and parent education and preparation, can also be effectively used to reduce VCUGassociated distress.[4] 2. Positioning For catheterization, the patient is supine, with the lower extremities in the frog-leg position. To obtain the necessary views, patients may have to be shifted to the lateral or oblique positions during the examination.[5] References 1. Broghammer J. 2008. Acute Management of Bladder and Urethral Trauma. 2. Goodman TR. 2012. Warm or cold contrast medium in the micturating cystourethrogram (MCUG): which is best?.

http://reference.medscape.com/medline/abstract/12834639. 3. Herd DW. 2008. Anxiety in children undergoing VCUG: sedation or no sedation?. http://reference.medscape.com/medline/abstract/18615194. 4. Agrawalla S. 2012. How to perform the perfect voiding cystourethrogram. http://reference.medscape.com/medline/abstract/14564427. 5. Barbaric ZL. 2012. Principles of Genitourinary Radiology.

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CYSTOGRAM

Cystogram merujuk pada pemeriksaan radiografi kandung kemih dan uretra, cystography merujuk pada pemeriksaan radiografi konvensional kandung kemih dengan media kontras ditanamkan melalui kateter uretra. Cystography memungkinkan evaluasi dari kedua cacat anatomi dan anomali fungsional. Cystogram diindikasikan untuk evaluasi lesi kandung kemih (misalnya, divertikula, benda asing, atau fistula), pecah, atau kebocoran. Indikasi untuk pencitraan trauma tumpul termasuk gross hematuria atau fraktur panggul nonacetabular dengan hematuria mikroskopik yang signifikan (> 25-30 sel darah merah [RBCs] per bidang daya tinggi [HPF]). [1] Kontraindikasi untuk cystogram meliputi: ISK klinis Aktif, Kehamilan, Alergi atau sensitivitas terhadap media kontras. Peralatan yang digunakan untuk cystogram meliputi: kit kateterisasi uretra steril dengan tabung, kateter uretra, sarung tangan steril, tape Bedah (untuk mengamankan kateter di posisi), tiang intravena (IV), fluoroskop atau rekaman gambar, media Kontras ( VCUG) idealnya harus dihangatkan sampai suhu tubuh, suhu reseptor di mukosa kandung kemih[2], pelindung/ perisai peralatan (misalnya, celemek timah dan perisai tiroid) untuk staf dan pengasuh di kamar. Pasien Persiapan : 1. Anestesi Sebuah tinjauan sistematis menemukan bahwa midazolam (0,5-0,6 mg / kg secara oral 30-45 menit sebelum prosedur atau 0,2 mg / kg intranasal sebelum prosedur) adalah aman dan efektif dalam mengurangi tekanan dan

tidak mengganggu dinamika berkemih.

[3]

nonfarmakologis metode, termasuk

pasien dan pendidikan orang tua dan persiapan, juga dapat secara efektif digunakan untuk mengurangi VCUG. [4] 2. Posisi Untuk kateterisasi, pasien terlentang, dengan ekstremitas bawah dalam posisi " frog-leg ". Untuk mendapatkan pandangan yang diperlukan, pasien mungkin harus bergeser ke posisi lateral atau miring selama pemeriksaan.[5] Daftar Pustaka 1. 2. Broghammer J. 2008. Acute Management of Bladder and Urethral Trauma. Goodman TR. 2012. Warm or cold contrast medium in the micturating cystourethrogram (MCUG): which is best?.

http://reference.medscape.com/medline/abstract/12834639. 3. Herd DW. 2008. Anxiety in children undergoing VCUG: sedation or no sedation?. http://reference.medscape.com/medline/abstract/18615194. 4. Agrawalla S. 2012. How to perform the perfect voiding cystourethrogram. http://reference.medscape.com/medline/abstract/14564427. 5. Barbaric ZL. 2012. Principles of Genitourinary Radiology.

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