When is cystography needed?
In case of pelvic trauma with blood in the urine, tight filling of the bladder (300–350 ml) and an image after emptying reveal contrast leaks: an intraperitoneal rupture requires urgent surgery, an extraperitoneal rupture is often treated with a catheter. Two projections allow you to see streaks and diverticula hidden behind the shadow of the bubble in a direct projection. Cystography also documents vesico-vaginal and vesico-intestinal fistulas and suture tightness after bladder surgery (before catheter removal). In case of tumors, cystoscopy and CT play the main role, cystography is auxiliary.
Indications
- urolithiasis - overview image to control X-ray positive stones;
- hydronephrosis, anomalies of the kidneys and ureters - excretory urography;
- urethral stricture, urethral trauma - urethrography;
- vesicoureteral reflux, diverticula, neurogenic bladder - cystography;
- control of drainage and patency after operations (antegrade pyelography, fistulography).
Place of x-ray for diseases of the urinary system
Although MSCT has largely replaced classical urography, X-ray techniques remain indispensable where a functional and “dynamic” picture is needed with a lower dose: monitoring the passage of stones using a survey image, assessing the urethra during urination (voice cystourethrography is the only way to see reflux and the posterior urethra), checking drainages and anastomoses with contrast. The studies are performed by a urologist and a radiologist at the clinic in conjunction, so the images are immediately interpreted in the context of treatment.
