In the digital era, the rise of misinformation is a serious hurdle to quality medical care. For families, the essentiality of making informed medical decisions in the best interests of their child can raise the stakes even higher. While no parent is perfect, evolving with the changing tides of the U.S. healthcare system is paramount to protecting your child’s safety and well-being.
While many healthcare professionals are courageously working to deliver a better standard of trauma-informed care, larger hospitals and medical institutions are less committed to improving the patient experience with quality care, especially if it means sacrificing record-breaking profits. With the billion-dollar VUR industry on the rise, the Unsilenced Movement is dedicated to educating families with the most accurate and up-to-date information about their child’s VCUG.
In this blog, we’ll explore 4 studies that directly contradict the promotion of VCUG by major hospitals in 2024.
Debunking Online Falsehoods About VCUG (2024)
The wealth of online misinformation about voiding cystourethrogram (VCUG) is a big reason why the Unsilenced Movement exists today. Regardless of whether they developed dissociative amnesia after their test, many VCUG patients end up doing a deep dive into the VCUG procedure in adulthood, seeking information to explain the debilitating effects of VCUG trauma. Prior to 2023, many of them were lucky to move past the overwhelming sea of misinformation and discover the only forum at the time that recognized VCUGs as traumatic.
To this day, page after page of search results from hospitals, providers, and radiology clinics keep the wealthiest, most prominent medical organizations front and center, painting a universal picture of the VCUG as a routine, painless, low-risk exam that requires no special preparation, nor produces any long-term effects. The Unsilenced Movement is committed to exposing glaring contradictions perpetuated by institutions that have profited off VCUG for over 33 years, despite compelling and extensive research.
Here are 4 (debunked) falsehoods in online VCUG promotions in 2024:
1. Your child won’t remember their VCUG.
Because VCUG is primarily performed on toddlers and preschool-aged girls, many providers reassure parents that their child won’t remember their test, extinguishing any concerns regarding its traumatic impacts in crucial early developmental stages. However, many researchers beg to differ, including the experts who conducted this 1994 study, one of many that equate VCUG trauma to child sexual abuse (CSA).
The researchers concluded that “the children’s recall of specific details of the VCUG experience was impressive. Analyses of the recall data indicated that [children] recalling the novel VCUG experience provided more details following open-ended questions than did the 5-year-olds in the study of the familiar well-child examination.” Not only that, but the children “responded accurately to misleading questions” over a six-week delay period.
2. The VCUG test doesn’t cause sexual trauma.
According to most major medical websites, the VCUG doesn’t lead to any long-term effects, nor does it inflict medical and sexual trauma. Again, research begs to differ. For a test that allegedly requires “no special preparation” or follow-up care, many patients go on to develop a myriad of adverse health effects due to sexual trauma from the procedure.
In this damning 2004 study, researchers used the VCUG test as a proxy for sexual abuse. “The VCUG procedure is painful and involves intrusive, forced genital contact,” the researchers explain. “Even the doctors administering the procedure admit that in many ways the VCUG procedure is similar to sexual assault on a child. The VCUG is not an elective procedure for the children.”
To demonstrate established similarities between VCUG and child sexual abuse, the study relied on the expertise of child sexual abuse counselors, who identified eight defining characteristics of child sexual abuse. Then, these features were blindly rated by 11 VCUG practitioners from Children’s Hospital of Los Angeles on a 1-4 scale to indicate whether the element was “almost always a feature of VCUG” (1) or “rarely a feature of VCUG” (4).
The study concluded that the majority of the features that defined child sexual abuse were also “at least frequently associated” with VCUG. “Five of the eight features received mean responses of 2.00 or less, indicating that these features were between almost always and frequently a feature of the VCUG procedure,” researchers confirmed. Two of the eight features were between frequently and occasionally features of the VCUG procedure, suggesting “a high rate of similarity” between sexual abuse and VCUG.
For resources about vaginismus and other effects of sexual trauma post-VCUG, visit our blog or read testimonies from former VCUG patients.
3. The VCUG is painless and minimally invasive.
Time and time again, we read the same message on top-ranking medical websites: The VCUG isn’t invasive. It isn’t painful. At worst, your child may feel some discomfort. Your child won’t feel anything after the catheter is inserted. While hospitals and clinics seem to regard VCUG as no different than a routine well-child exam, a series of studies dating back to 1990 have established that this test is often experienced in the same way as child sexual abuse (CSA).
In one such study (1999), Dr. Gail S. Goodman “examined children’s long-term memory for a documented medical procedure, voiding cystourethrogram fluoroscopy (VCUG), that involves painful and stressful genital contact.” She reiterates the invasive nature of VCUG in her conclusion, defining the test as “a stressful event” involving “invasive genital contact.” While some adults may scoff at the idea of a catheter being invasive, the pediatric patient experience tells a different story—one that clearly warrants more consideration and sensitivity, especially from medical personnel.
VCUGs are primarily performed on preschool-aged little girls, most of whom are:
Naked with genitalia exposed.
Alone without a parent in the presence of numerous radiology staff.
Strapped onto the table or forcibly restrained by multiple adults, who will hold their legs open to proceed with forced catheterization if the patient resists or complains of pain during the test.
4. The VCUG doesn’t have any long-term risks.
The long-term effects of the VCUG procedure are extensive and well-documented. However, most websites merely caution parents about ionizing radiation, which is frequently dismissed as a negligible risk (to learn more about the wide variations in radiation doses for VCUG, check out our recent post about VCUG protocol).
Few institutions bother to list any additional risks of the procedure. “Your child needs no special care after this test,” writes Kaiser Permanente, a non-profit healthcare company with operations in 8 states, 39 hospitals, and more than 700 medical offices with over 300,000 personnel. “Your child can return to his or her normal activities right away…He or she may also notice some burning during and after urination.”
Beyond radiation and pink urine for up to 12 hours, hospitals are typically silent about the longer-term effects of VCUG. Medical researchers, however, are not. For instance, this 2014 study lists several post-VCUG complications, including “UTI, hematuria, cystitis as well as urinary dysfunction following a catheterization, phobia of urination, nocturia, and stopping urination.” Moreover, the researchers continue, “In the literature, psychological trauma resulting from VCUG was considered the same as from a violent rape, especially in girls.”
At the Unsilenced Movement, we are those girls—and we refuse to stay silent any longer.
Find Your Voice with the Unsilenced Movement
In 2023, the Unsilenced Movement was founded to give former VCUG patients a voice after 33 years of invalidation and lasting health effects—and most importantly, zero modifications to the “gold standard” VCUG procedure. Learning that this procedure is still widely performed on other little girls today gave us the courage to stand up, speak out, and demand change.
While we can’t go back and stop our tests from happening, we can fight tooth and nail to save other children from the same fate. If medical personnel insist on performing the VCUG test without a single change in over 33 years, then we, as former patients, must insist on disclosing the real risks to families, parents, and patients. Join the Unsilenced Movement to hold physicians accountable under the informed consent doctrine and fight for overdue reform in pediatric urology.
Because kids deserve better. #MoreThanATest
The evidence of the medical profession's failure to safeguard chldren from the harms of this procedure is absolutely DAMNING.
VCUGs have been in common use since the early to mid 1960s. So while the research about the known harms dates back 34 years, it is 60+ years that the medical community has been inflicting severe trauma on our vulnerable little ones. How many millions of innocent children have suffered sexual trauma at the hands of a profession that has so much power, it sees no need to hold itself held accountable to principles of do no harm. It is ethically indefensible to ignore and bury the studies that show the true nature of the harm being done to children at their hands. We must return power to ourselves from those who would knowingly damage the most vulnerable membe…