Cystography

CYSTOGRAPHY

Cystography is an invasive radiographic procedure in which contrast
medium is introduced into the urinary bladder via a catheter and images
are obtained using X-ray or fluoroscopy to evaluate bladder anatomy and
pathology.


Anatomy




 Urinary bladder is a hollow muscular organ in the pelvic cavity
that stores urine
 Located behind pubic symphysis
 Capacity: 300–500 ml (adult)
 Parts: Apex, body, fundus (base), neck
 Openings: 2 ureters (inlet) + 1 urethra (outlet)
 Trigone: Smooth triangular area, important clinically

 Wall:
 Mucosa (transitional epithelium)
 Muscle (detrusor)
 Function: Storage and expulsion of urine

, INDICATIONS
 Bladder trauma → detect rupture or leakage
 Vesicoureteral reflux (VUR)
 Bladder tumors
 Diverticulum (outpouching)
 Urinary incontinence
 Congenital abnormalities
 Post-operative evaluation of bladder
 Fistula detection (abnormal connection)


CONTRA-INDICATIONS
 Acute urinary tract infection (UTI)
 Severe urethral injury (avoid catheter insertion)
 Recent bladder surgery (risk of rupture)
 Active bleeding in urinary tract
 Allergy to contrast media (relative contraindication)
 Pregnancy


CONTRAST MEDIA

Type: Water-soluble iodinated contrast
Preferred: Non-ionic (low osmolar, safer, less irritation)
Route: Retrograde instillation through Foley catheter
Volume Adults: 300–500 ml
Children: According to age/weight
Properties Radiopaque
Non-toxic
Easily excreted
Purpose Outline bladder wall
Detect:
Rupture
Vesicoureteral reflux