Advanced Search
Korean J Pediatr 2012 May;55(5) :181-184.
Published online 2012 May 15.        doi:
Urinary bladder rupture during voiding cystourethrography
Kyong Ok Lee (Lee KO)1, Se Jin Park (Park SJ)2, Jae Il Shin (Shin JI)1, Suk Young Lee (Lee SY)3, Kee Hyuck Kim (Kim KH)4
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
3Departments of Urology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
4Departments of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
Corresponding Author: Kee Hyuck Kim ,Tel: +82-31-900-0520, Fax: +82-31-900-0049, Email:
Copyright © 2012 by The Korean Pediatric Society
Voiding cystourethrography (VCUG) is a commonly performed diagnostic procedure for the evaluation of vesicoureteral reflux with urinary tract infection or congenital renal diseases in children. The procedure is relatively simple and cost-effective, and complications are very rare. The iatrogenic complication of VCUG range from discomfort, urinary tract infection to bacteremia, as well as bladder rupture. Bladder rupture is a rare complication of VCUG, and only a few cases were reported. Bladder rupture among healthy children during VCUG is an especially uncommon event. Bladder rupture associated with VCUG is usually more common in chronically unused bladders like chronic renal failure. Presented is a case of bladder rupture that occurred during a VCUG in a healthy 9-monthold infant, due to instilled action of dye by high pressure. This injury completely healed after 7 days of operation, and it was confirmed with a postoperative cystography. The patients bladder volume, underlying disease, velocity of the contrast media instilled, catheter size, and styles of instillation are important factors to prevent bladder rupture during VCUG. Management of bladder rupture should be individualized, but the majority of infants are treated with the operation. In conclusion, bladder rupture is a rare complication, however, delicate attention is needed in order to prevent more dire situations.
Keywords: Urinary bladder | Rupture | Radiography
1. Riccabona M. Cystography in infants and children: a critical appraisal of the many forms with special regard to voiding cystourethrography. Eur Radiol 2002;12:2910–2918.
2. McAlister WH, Cacciarelli A, Shackelford GD. Complications associated with cystography in children. Radiology 1974;111:167–17
3. Zerin JM, Shulkin BL. Postprocedural symptoms in children who undergo imaging studies of the urinary tract: is it the contrast material or the catheter?. Radiology 1992;182:727–730.
4. Lim JH, Jeon SB, Park JS, Cha JS, Kim MK, Jeong YB, et al. Bladder rupture during voiding cystourethrography. Korean J Urol 2007;48:230–232.
5. Rachmiel M, Aladjem M, Starinsky R, Strauss S, Villa Y, Goldman M. Symptomatic urinary tract infections following voiding cystourethrography. Pediatr Nephrol 2005;20:1449–1452.
6. Glynn B, Gordon IR. The risk of infection of the urinary tract as a result of micturating cystourethrography in children. Ann Radiol (Paris) 1970;13:283–287.
7. Weese DL, Greenberg HM, Zimmern PE. Contrast media reactions during voiding cystourethrography or retrograde pyelography. Urology 1993;41:81–84.
8. Wood BP, Lane AT, Rabinowitz R. Cutaneous reaction to contrast material. Radiology 1988;169:739–740.
9. Konen O, Pomeranz A, Aronheim M, Rathaus V. A urethral catheter knot: a rare complication of cystourethrography. Pediatr Radiol 1996;26:757–758.
10. Crowley JJ, McAlister WH. Extravasation of contrast material during voiding cystourethrography. Abdom Imaging 1995;20:68–69.
11. Kim MS, Lee SH, Kim JH, Chang YB, Lee DY. Study of post procedural complications associated with voiding cystourethrography. J Korean Soc Pediatr Nephrol 2007;11:65–73.
12. Matsumoto AH, Clark RL, Cuttino JT Jr. Bladder mucosal tears during voiding cystourethrography in chronic renal failure. Urol Radiol 1986;8:81–84.
13. O'Brien WJ, Ryckman FC. Catheter-induced urinary bladder rupture presenting with pneumoperitoneum. J Pediatr Surg 1994;29:1397–1398.
14. Holmdahl G, Hanson E, Hanson M, Hellstrom AL, Hjalmas K, Sillen U. Four-hour voiding observation in healthy infants. J Urol 1996;156:1809–1812.
15. Hjalmas K. Urodynamics in normal infants and children. Scand J Urol Nephrol Suppl 1988;114:20–27.
16. Peter GS, Akira K, Carl S, Bruce JB, Lamk ML, Stanford MG. Urinary tract imaging-basic principles. In: Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ, Kavoussi LR, Novick AC, et al.Campbell's urology. 8th ed. Philadelphia: Saunders; 2002. pp. 130-131.
17. Robson WL, Leung AK, Thomason MA. Catheterization of the bladder in infants and children. Clin Pediatr (Phila) 2006;45:795–800.
18. Agrawalla S, Pearce R, Goodman TR. How to perform the perfect voiding cystourethrogram. Pediatr Radiol 2004;34:114–119.
19. Al Dean, Jr;JK. Lattimer,CB McCoy.The standardized Columbia University cystogram. J Urol 1957;78:662–668.
20. Jequier S, Jequier JC. Reliability of voiding cystourethrography to detect reflux. AJR Am J Roentgenol 1989;153:807–810.
21. Caroline DF, Pollack HM, Banner MP, Schneck C. Self-limiting extravasation in the unused urinary bladder. Radiology 1985;155:311–313.
22. Oktar T, Sanli O, Atar A, Ozcan F, Ander H, Ziylan O. Iatrogenic bladder rupture in a child following voiding cystourethrography and its laparoscopic management. Eur J Pediatr Surg 2011;21:275–277.
23. Khavari R, Bayne AP, Roth DR. A report of an iatrogenic bladder rupture in a normal healthy child during voiding cystourethrography. Urology 2010;75:684–686.
24. Kajbafzadeh AM, Saeedi P, Sina AR, Payabvash S, Salmasi AH. Infantile bladder rupture during voiding cystourethrography. Int Braz J Urol 2007;33:532–535.
25. Cam H. Bladder rupture following voiding cystourethrography. Indian Pediatr 2006;43:179–180.
26. Wosnitzer M, Shusterman D, Barone JG. Bladder rupture in premature infant during voiding cystourethrography. Urology 2005;66:432.
27. Trulock TS, Finnerty DP, Woodard JR. Neonatal bladder rupture: case report and review of literature. J Urol 1985;133:271–273.
PDF Links  PDF Links
Full text via DOI  Full text via DOI
  via Pubmed
Full text via PMC  Full text via PMC
via Pubreader  via PubReader
Download Citation  Download Citation
Supplementary Material  Supplementary Material
Register for e-submission
Register here to access the e-submission system of Korean J Pediatr for authors and reviewers.
Manuscript Submission
To submit a manuscript, please visit the Korean J Pediatr e-submission management system at, read the Instructions for Authors, and log into the Korean J Pediatr e-submission system. For assistance with manuscript submission, please contact:
Free archive
Anyone may access any past or current articles without logging in.
Korean Pediatric Society Office
#1606, Seocho World Officetel, 19 Seoun-ro, Seocho-gu, Seoul 137-070, Korea
TEL : +82-2-3473-7305    FAX : +82-2-3473-7307   E-mail:
BrowseCurrent IssueFor Authors and ReviewersAbout
Copyright© The Korean Pediatric Society. All right reserved.