Mixed cystography or mixed cystourethrography [1] is a method of x-ray examination of the bladder and adjacent organs of the urinary system during the act of urination [2] . During urination, a radiopaque substance penetrates the urethra ( lat. Urethra ), therefore, this diagnostic method allows you to judge the state of the urethra, the bladder. Mixed cystography also provides very valuable information in the diagnosis of vesicoureteral reflux .
Content
- 1 Description of the method
- 2 Interpretation of results
- 3 notes
- 4 References
Description of the method
Before conduction of mycystic cystography, it is recommended that the patient undergo general preparation, as with other methods of X-ray examination of the urinary system: for two days, limit the intake of products that stimulate gas formation in the intestine , conduct a cleansing enema on the eve of the study, in the evening , and in the morning , immediately before the procedure.
Then, using a catheter inserted through the urethra into the bladder, a radiopaque substance is injected (the variety and quantity are selected at the discretion of the specialist). Thus, before taking a picture, the contrast is in the bladder. Next, the patient is asked to urinate and already in the process of committing the act of urination, the radiologist makes an x-ray. Some authors recommend taking a picture not only during urination, but before it, immediately after filling the bladder with an radiopaque substance. [3]
Interpretation of results
In the first picture, you can visualize the bladder, which gives a shadow in the form of a transverse oval , the lower contour of which lies at the level of the upper edge of the pubic bones . In the absence of pathological formations in the bubble (stones, tumors), its shadow is completely uniform.
In the second picture (taken during urination), you can visualize the urethra and judge its condition. However, the method of mixed cystography for the study of the urethra is practically not used, since there are more advanced methods for this. The main purpose of mycotic cystography is that it allows you to detect vesicoureteral reflux . The fact is that when urinating, the muscle that expels the urine becomes tense ( Latin m. Detrussor urinae ), and the intravesical pressure increases, the muscle fibers enveloping the final part of the ureters (act as sphincters that prevent urine from being blown out of the bladder) can not cope with their task and urine, with contrast dissolved in it, enters the ureters. Therefore, in persons suffering from PMR , the ureters will also be visualized in the second image.
Notes
- ↑ Alexandra Sergeevna Gurskaya, L. B. Menovshchikova, M.V. Levitskaya, O.G. Mokrushina, V.S. Shumikhin, A.I. Gurevich, E.V. Yudina. Diagnosis and treatment of newborns and young children with valves of the posterior urethra // Andrology and genital surgery : journal. - 2014. - T. 15 , No. 2 . - S. 44–47 . - ISSN 2412-8902 .
- ↑ Medical radiology (basics of radiation diagnostics and radiation therapy): Textbook. - 2nd ed., Revised. and add. - M.: Medicine, 2000.— 672 s: ill. (Textbook. Lite. For students of medical universities). (354 pp.) ISBN 5-225-04403-4
- ↑ Bladder-ureteral reflux in children (Inaccessible link) . Date of treatment October 9, 2011. Archived November 22, 2011.