5 Facts About VCUG That You Won't Find Online

In this blog, we review 5 FAQs about pediatric VCUG that you won't find online.

VCUG is the “gold standard” diagnostic test for kidney reflux (VUR) in children. Unfortunately, many caregivers cannot give informed consent for their child’s procedure due to a longstanding lack of disclosure about VCUG trauma, which includes well-evidenced similarities to child sexual abuse.

The vast majority of clinical websites promote VCUG as safe and routine with a low-risk profile. Most describe the test as “painless” or uncomfortable at worst. For many patients, this couldn't be further from the truth.

5 Facts About VCUG That Hospitals Don't Mention

1. The VCUG test is painful for many children.

When we refer to “VCUG patients,” we are largely referring to newborns, infants, toddlers, and preschool-aged children. This procedure most often involves involuntary catheterization while the child has an active UTI. Consequently, VCUG is painful for many children.

Despite this, complaints of pain from pediatric patients are routinely dismissed as ingenuine, exaggerated, or attention-seeking behavior. “It's just soap and water,” one survivor remembers the nurse saying when she resisted painful genital cleaning, while naked and restrained against her will.

2. The VCUG test is also difficult for observers and medical personnel.

Many parents and medical personnel struggle to stay in the room for VCUG. In some cases, nurses and Child Life Specialists are not properly prepared for their task and may develop secondary trauma after witnessing the procedure. Medical students in attendance have been known to walk out of the room before the test is completed due to discomfort. On one occasion, a nurse said that being present during the VCUG “felt like we were molesting [the child].”

3. The VCUG test is not routine or forgettable for young patients.

Current promotions of VCUG border on negligence. The few hospitals that offer prepatory resources do little to improve the lack of informed consent for VCUG. “Relatively painless,” concludes one pamphlet aimed at preparing families, adding that “no special preparation is needed” for VCUG.

4. Most children don’t just “forget” their VCUG.

Most hospitals promote the VCUG test as painless, low risk, and safe. At best, doctors may inform parents that VCUG is "a little uncomfortable." This isn't the case, as evidenced by extensive testimonies from former patients.

5. There are safe and available sedation methods for VCUG.

Today, the majority of providers don’t offer sedation for VCUG, despite the availability of safe, effective sedation methods. Most hospitals assert that sedation compromises test results. This is not the case. Many children benefit from sedation while still being able to void. Learn more in this 2012 article from a seasoned pediatric radiologist.

What Are the Risks of VCUG?

Short-term risks of VCUG include:

• Urinary bladder rupture due to overfilling of contrast dye

• Urosepsis and death as a result of VCUG-related UTIs

• Developmental regression

• Nightmares and sleep disturbances

• Personality changes

• Blood in urine and pain when urinating

Long-term risks of VCUG include:

• Increased cancer risk, especially in the genitourinary system

• Susceptibility to abuse in adulthood, especially in sexual and medical settings

• Long-term avoidance of medical care

• Sleep disturbances and nightmares

• Memory loss (dissociative amnesia)

• Post-traumatic stress disorder (PTSD)

• Traumatic reenactment ("traumatic play")

• Pelvic floor dysfunction

• Difficulty with sex and intimacy

• Depression and anxiety

• Isolation, especially from any family members during the test

• Active and passive suicidality

• Vaginismus or pain with vaginal penetration

Can Sedation Prevent VCUG Trauma?

While sedation can be beneficial, there is never a guarantee that children will walk away less traumatized as a result. In some cases, former VCUG patients who were sedated during the procedure still experience severe trauma. 

This is largely because, in the majority of cases, children are still fully aware of what's happening and can feel everything. The only difference is being unable to move their bodies or speak, an experience some survivors describe as akin to date rape.

One former patient sedated for "severe distress" during her procedure repressed the memory, but relived it in a nightmare well into young adulthood, unable to move as she witnessed the forced instrumentation of her lower body by male doctors.

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• Explore our blog and resources for parents, patients, and providers.

Advocating for VCUG Patients Since 2023

Our grassroots organization was founded by former VCUG patients whose lives were irreparably changed by VCUG. If your child was referred for a VCUG procedure, the Unsilenced Movement is here to offer support.

Join the Unsilenced Movement to advocate for overdue VCUG reform. Because kids deserve better. #MoreThanATest