Unfortunately, urological pathologies are very common. Diseases of the genitourinary system are common not only in adults, but also among children. In order to start treatment on time and prevent the chronic course of pathology, it is necessary to conduct a diagnosis. Identification of ailments is carried out using various instrumental and laboratory studies. One of the diagnostic methods is cystography. This is an unpleasant procedure, but in some cases it is considered necessary. Therefore, when assigning this study, parents are interested in: why is cystography performed in children, how is it done, what is needed for preparation? Consult on these issues with your doctor.
What is cystography?
Any doctor can answer the question of how cystography is done in children, nevertheless, to find out all the nuances, it is better to contact a urologist or a specialist in functional diagnostics. First of all, you should know that this examination method is used to visualize the bladder. Cystography in children is a diagnostic procedure performed using an x-ray machine. Before taking a picture of the genitourinary system, you must enter a contrast medium. This research method is carried out with suspicion of various urological diseases. It is also necessary before surgery. The organs that are visualized during cystography are the bladder and the pyelocaliceal system of the kidneys. This procedure is performed in various ways, therefore, before preparing for it, it is necessary to clarify how cystography is done in children in a particular case. You should also know that there are contraindications for this study.
Cystography in children: how to do it, x-ray photo
Before cystography, a contrast agent must be introduced into the urinary tract. Therefore, this procedure is painful. This is especially true for children. For this reason, the child needs to be mentally prepared for the study. It is important to explain how cystography is done to children: boys and girls. This is important, because the structure of the urethra in men and women has significant differences. You also need to tell the child: why do cystography and how important it is. If you prepare the baby correctly, then the study will not scare him. To learn more about this diagnostic method, you can see photos of x-ray images in this article. This will help to understand what changes are visualized through the examination.
Options for cystography
Depending on the method of administration of the contrast medium, 2 types of cystography are distinguished. Among them:
- Descending. It is carried out by introducing a dye into a vein. After some time, the contrast medium fills the bladder and an x-ray can be taken.
- Ascending cystography. Contrast is introduced into the urethra - the urethra. Thus, organs can be visualized faster. This method is used more often, as it is more convenient. Nevertheless, there are contraindications to this study. In such cases, a downward cystography is performed.
Since the diagnostic method involves the introduction of a catheter into the urethra, the procedure delivers an unpleasant sensation. Also, during an X-ray examination, the device can make loud noises, which usually scares the kids. This should be warned by the parents and the child. Another option for the procedure is counting cystography, it is performed at the time of urination. This method allows you to diagnose a wider range of urological pathologies.
What are the indications for cystography?
In addition to explaining how cystography is done in children, parents should also be advised of why this unpleasant examination is needed. To carry out this diagnostic method, the following indications exist:
- Suspected bladder tumor.
- Birth defects.
- Stones or sand in the ureters.
- Enuresis.
- Genitourinary tuberculosis.
- Reflux. This condition occurs when urine is thrown back into the kidneys. This is a dangerous syndrome, as it leads to chronic pathologies.
- Suspected complications after infectious diseases.
Symptoms of all these pathologies are similar, therefore it is impossible to diagnose a particular illness only according to the clinical picture. The following complaints may be the reasons for examination: pain, urinary incontinence, frequent urges.
In what cases is cystography contraindicated?
Before conducting an x-ray examination, the doctor prescribes many laboratory tests. They are needed to find out if there are contraindications to performing cystography. You should know that this diagnostic method can not be carried out with inflammatory processes of the urination organs. These include: cystitis, urethritis, pyelonephritis. All of these diseases can be detected through general and special urine tests. In some cases, an ultrasound scan is required before performing cystography. It helps determine if the bladder and kidneys are inflamed. All of these pathologies are contraindications for ascending cystography, since the implementation of this method involves the introduction of a catheter. With inflammation, the instrument will only increase pain, and can also aggravate the infection process. In these cases, the study should be postponed until the child recovers. In cases where cystography is urgently needed, it is performed in a top-down manner. Also a contraindication is an allergy to contrast agents. Whether a child has an increased reactivity of the immune system, you should definitely find out before prescribing such diagnostic methods.
Preparing the child for research
After explaining how cystography of the ureters in children is done, you need to tell parents in detail about the preparation for it. Since an X-ray examination is undesirable several times in a row, you should follow the doctor’s instructions in advance. Preparation for cystography includes bowel cleansing. For this purpose, the baby is prescribed a diet 2 days before the study. Soda drinks, cabbage should be excluded from the child’s diet. To remove excess gas, a baby can drink a few tablespoons of decoction from dill seeds. A cleansing enema should be done in the morning, immediately before the cystography. In addition, when preparing children with a tendency to allergic reactions, it is necessary to test contrast tolerance.
Procedure Technique
In order for the results to be reliable, it is necessary to observe the technique of performing cystography. This procedure includes the following steps:
- Giving the child a level position on the x-ray machine. The first picture is taken before the introduction of a contrast medium. During the study, the child should not move.
- The introduction of contrast. The amount of coloring matter depends on the age of the patient. If this is a young child, then he needs to enter from 50 to 100 ml. Children from 12 years old are given the same dose as adult patients. It is 200-300 ml. As a contrast, substances “Urografin”, “Iodamide” are used.
- Insertion of a catheter into the urethra.
- Repeated x-ray examination in direct and lateral projections.
- Monitoring the condition of the child after the procedure.
Cystography in infants is carried out only in case of special need. This is due not only to the painfulness of such a diagnostic method, but also to the harmful effects of x-rays on the baby's body. Nevertheless, there are cases when it is impossible to do without cystography. These include a suspicion of congenital malformations of the genitourinary system, fistulous passages. With these conditions, surgical intervention is required at an early age.
What can be seen in the pictures: decryption
After receiving information about how cystography is done in children, the patient's parents begin to wonder: what can be seen in the pictures. Deciphering the results is as follows:
- Assessment of the size, shape and location of the urinary system. All this is visualized in the original (first) image.
- Definition of pathological formations or reflux.
Thanks to this diagnostic method, it is possible to see the expansion of the ureters, compare them with each other. Also, X-ray images visualize the reverse reflux of urine into the pyelocaliceal system of the kidney - reflux. In the presence of fistulas, the contrast medium exits through the hole, which should not be normal. Stones or tumors in the bladder are visualized after filling. In the presence of any formations, pneumocystography is required (introducing gas into the organ cavity). If there are stones in the ureters, the contrast agent cannot pass through them. Thanks to the changes visualized in the pictures, one can judge the presence of various pathologies.
Cystography in children. How to do it: patient reviews
Despite the benefits of cystography, parental reviews are not always positive. This is due to the pain of the procedure. Nevertheless, when identifying the disease and timely assistance, patients remain satisfied. Indeed, despite the unpleasant sensations, the result of this study is necessary for making a diagnosis.