What is an MCU Test (Micturating Cystourethrogram)?
MCU is a special X-ray procedure done to evaluate any abnormalities in the bladder neck, narrowing of urethra or reflux of urine into kidneys.
When is an MCU Test Recommended?
MCU is done when we suspect a malfunction in the bladder, like a reverse flow of urine from the bladder to the kidneys, in outflow urinary passage like stricture, (or) anatomical defects like bladder diverticulum, urinary fistulas, etc. It is done only after basic blood & urine tests & ultrasound study of the urinary tract is completed.
How is an MCU Test Performed?
A suitable quantity of contrast medium is “injected” into the bladder through the suprapubic region. You are supposed to hold your urine till such time you have urgent desire to pass urine. An ultrasound scan will be done before the procedure to ascertain bladder fullness. Only in children < 2 years, the contrast is instilled into the bladder by a small tube inserted through urethra. Then you have to pass urine, in standing position on a special stand, with one leg flexed at the knee and hip joint. While you are passing urine, X-rays will be captured. You will be told to stop the urine stream, once X-ray film is captured. This step needs to be repeated 2-3 times to complete the study.Adequate privacy will be provided during the procedure, like switching off lights, to help you feel comfortable during the voiding of urine.
Please note:
- This procedure does not require any preparation
- You need to hold urine till the bladder is full, for the suprapubic technique
- This procedure does not involve any adverse reaction of the contrast agent used
- In case of female patient, who are pregnant/have a possibility of pregnancy, this procedure should not be done. Immediately intimate your doctor
- In case of children, the parents have to explain the child about the procedure and prepare him/her mentally for the same
- This test can’t be done in case you have an active infection of bladder/have a constant dribble of urine
Step-by-Step MCU Test Procedure
A local anesthetic cream is applied to the area below the umbilicus, at least 1 hour prior to the procedure. When you are ready to pass urine, an ultrasound scan will be done to measure your bladder volume. Then, under the influence of the local anesthesia, the skin is punctured and the contrast (a special solution which looks opaque on the x-ray) is injected into the bladder. This part of the procedure has a very little discomfort, which is the pain of an injection. In case, your child undergoing the procedure is less than 2 yrs of age, then the contrast is instilled through a catheter introduced via the urinary passage. This too is performed after instilling sufficient local anesthesia. X-ray is taken now. You will then need to stand and pass urine, during which a few more X-rays will be taken. You will need to stop urination immediately after the x-rays and this may be repeated once (or) twice to complete the study.
How to Prepare for an MCU Test?
Yes, the investigation needs to be done when you feel like passing urine (the sensation at which you would normally pass urine) for this you need to drink plenty of water and not pass urine, for 3 to 4 hours prior to the appointment. In case your child is more than 2 years and is undergoing this investigation, you will need to prepare him/her mentally about the steps involved in the investigation. For those children the X-ray will be done in lying down position as they have automatic bladders & they are not made to stand up.
Any specific advice ?
The investigation cannot be done in case of females, who are pregnant or have missed their monthly cycles. Even otherwise, the X-ray exposure will be kept to a minimum.It is not done in case there is a suspicion of bladder tumour (or) infection. In people with active infection of the bladder, the infection needs to be treated before the procedure and the treatment may need to be continued after the procedure also.
It is not done in case there is a suspicion of bladder tumour (or) infection. In people with active infection of the bladder, the infection needs to be treated before the procedure and the treatment may need to be continued after the procedure also.
It is not done in case there is a suspicion of bladder tumour (or) infection. In people with active infection of the bladder, the infection needs to be treated before the procedure and the treatment may need to be continued after the procedure also.
Is the MCU Test Painful or Embarrassing
Passing urine in a different environment such as the radiology suite is certainly difficult. However, adequate privacy will be provided during the procedure, with the lights switched off, with only the required minimum people in the hall (even these people will not be in your view) and minimum noise, to help you feel comfortable during urination.
Risks and Side Effects of MCU Test
You may feel a burning sensation while passing urine and urine may be blood tinged for a few hours following MCU test. In case of fever, following the procedure, report the same to your doctor immediately.
When to Expect MCU Test Results?
The images are uploaded immediately. Depending upon your doctor’s availability, you can consult the doctor. Compact disc (CD) of the images will available after 1 hour and is given at no extra cost. A printed report will be available by next 1 working day. And you can ask the radiographer to email the report to your email ID or you can collect hard copy.
Will further tests be needed or will the same be repeated ?
This depends on the results of the test. Further tests may be needed and will be decided by your doctor. The test may have to be repeated rarely, if no voiding film was captured (due to urgency). In that case it may be repeated same day or another day.
