Auckland Radiology Group

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Information for parents and families of children.

What is an MCU?

An MCU is an x-ray test of the bladder as it fills and empties. An ultrasound of your childs kidneys and bladder may be performed immediately before or after the MCU.

Why is your child having this test?

Probably because your child has had a urinary infection or an abnormal ultrasound of the kidneys. The MCU allows us to look for 'reflux'. This medical term describes the abnormal passage of some urine back up the tubes (ureter) to the kidneys when a child urinates (wees). Normally when a child passes urine all the urine drains down from the bladder through a tube (the urethra), which opens just above the vagina in girls or at the tip of the penis in boys.

Reflux is important because when present it can potentially damage the kidneys. In the long term this damage if severe may cause high blood pressure and renal failure.

Children under the age of 1 year require a prescription to be obtained from your GP for a 3-day course of prophylactic antibiotic cover commencing the day before the MCU.

How is an MCU done?

After changing into a gown and emptying their bladder (if toilet trained) your child lies on an x-ray table. If under 4 years they will usually lie in a cradle so they can be gently restrained for their safety and to make the test quicker. The area around the urethra is cleaned with a mild disinfectant before a catheter (a soft thin plastic tube) is passed up the urethra into the bladder. The catheter connects to a bottle of solution containing contrast (dye). The bladder is slowly filled. The contrast allows the bladder to be seen on x-rays. Infants not toilet trained will pass urine around the catheter when the bladder is full. Older children find it harder and require gentle encouragement to urinate on the table. X-rays are taken while urinating. The doctor checks these; if they are okay the catheter is removed. The solution is washed off before a final x-ray is taken.

The catheterisation can be uncomfortable, more so for boys because of their longer urethra. In older boys local anaesthetic jelly can be used to make the catheterisation easier.

Apart from the catheterisation the test is relatively painless. Children do find having a full bladder uncomfortable but this passes when they empty their bladder. Most children find the procedure more frightening than painful. Please feel happy to bring along comforters or any toys that will reassure your child.

Sedation

The procedure can be performed under sedation, suitable for children over 18 months of age and less than 35kgs in weight.

The sedation (Midazolam), given orally 20-30 minutes before the procedure helps the child to relax for the MCU and have little or no recall of the event.

Are there any after effects from an MCU?

Usually there is none.

1.		There may be a slight tinge of blood in the urine. This is a temporary phenomenon and will disappear within 24 hours. If it does not please call us. It is important that a high fluid intake is maintained after the MCU at least for 24 hours.

2.		There may be discomfort in the urethra when passing urine. Some small children will avoid passing urine because of the discomfort. Should this occur we would recommend sitting them in a warm bath and allowing them to pass urine in the bath.

3.		Occasionally a bladder infection may follow an MCU. When reflux is discovered on the MCU an antibiotic will normally be required subsequently. It is important that a prescription be obtained either from the radiologist at the time of the MCU or soon thereafter from your own GP.

What to tell your child about an MCU.

It is important to tell your child what will happen in simple language that you know they can understand. The day beforehand is usually long enough. Children need to be able to trust their families and they feel tricked if they are told nothing of what will happen. How much you tell your child will depend on how old they are.

•		They are coming with you to have a special kind of photograph taken.

•		Tell them that this is important and why it is necessary (eg. Because they have had an infection or a sore tummy or pain when passing urine).

•		They will go straight home afterwards and will not have to stay the night.

•		You will be with them all of the time.

•		They will need to change out of their own clothes.

•		They will be asked to lie on a special table and to be relaxed as they can (you can show your child this with a teddy bear or rag doll). If your child is over 4 years of age he or she may like to practice with you lying down with relaxed floppy legs.

•		A fine soft tube will be slid into the opening where they pass urine (use words which your family uses for this part of the body and which are familiar to your child). This may feel uncomfortable but it will be over as quickly as possible.

•		Older children need to know that they will be asked to pass urine while they are on the special table and that it will not matter if the table or their clothing get wet.

•		That you and the doctor and nurses will understand if he or she feels shy or embarrassed.

How are the results communicated?

The Radiologist will interpret the x-ray films and make a written report to your doctor. The Radiologist will be able to discuss the results with you at the time of the examination.

If you have any questions about this study, it's preparation etc please feel free to phone Auckland Radiology Group for advice. Ph 529 4850 and talk to the Booking Co-ordinator.

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