Radiology Procedure (M. C. U.)

                (  M. C. U.)

M.C.U. stands for Micturating Cystourethrogram (also called Voiding Cystourethrogram – VCUG). It is a specialized radiologic procedure used primarily in pediatric and urologic imaging.


🔹 Definition

Micturating Cystourethrogram (MCU) is a fluoroscopic imaging study of the urinary bladder and urethra, performed while the bladder is being filled with contrast and during voiding (urination). It evaluates the function and structure of the lower urinary tract.

🔹 Indications

MCU is indicated in:

  • Vesicoureteral reflux (VUR) – most common indication
  • Recurrent urinary tract infections (UTIs), especially in children
  • Posterior urethral valves (PUV) – in male children
  • Urethral strictures or obstructions
  • Congenital anomalies of the urethra or bladder
  • Bladder trauma or neurogenic bladder
  • Enuresis (bedwetting) when anatomical cause is suspected

🔹 Contraindications

  • Active urinary tract infection (UTI) – procedure should be delayed until infection resolves
  • Allergy to contrast media (iodinated contrast)
  • Recent urologic surgery or trauma (relative contraindication)

🔹 Contrast Used

  • Water-soluble iodinated contrast (non-ionic preferred in children, e.g., Iohexol or Iodixanol)
  • Contrast is introduced via urethral catheterization into the bladder.

🔹 Patient Preparation

For Children:

  • Explain the procedure to parents and child (age-appropriate)
  • Use distraction techniques or mild sedation if needed
  • Obtain informed consent
  • Rule out UTI with urine culture (especially in children)

For Adults:

  • Explain the procedure and obtain consent
  • Encourage voiding before the study

🔹 Radiologic Method

  1. Catheterization: A urinary catheter is inserted aseptically into the bladder.
  2. Bladder Filling: Iodinated contrast is instilled slowly under fluoroscopy.
  3. Imaging During Filling: Serial images are taken to assess the bladder contour and presence of reflux into the ureters/kidneys.
  4. Voiding Phase: Catheter is removed, and patient is asked to void while images are taken (especially of the urethra).
  5. Post-void Film: Taken to assess residual urine and any delayed reflux.

🔹 Films Taken

  • Scout film (before contrast)
  • Bladder filling phase images (AP and oblique views)
  • Voiding phase images (AP for males, lateral for females)
  • Post-void image
  • Delayed images if reflux is suspected

🔹 After Care

  • Observe the patient for signs of discomfort or infection
  • Encourage oral fluid intake to flush out the contrast
  • Watch for dysuria, hematuria, or fever (UTI signs)
  • Antibiotic prophylaxis may be considered in children after the procedure

🔹 Diseases Diagnosed

  • Vesicoureteral reflux (VUR)
  • Posterior urethral valves (PUV)
  • Urethral strictures
  • Bladder diverticula
  • Neurogenic bladder
  • Bladder outlet obstruction
  • Duplicated ureters
  • Trauma-related bladder/urethral injury


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