Intravenous pyelogram

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Kidney anatomy

Kidney - blood and urine flow

Intravenous pyelogram

Overview

Risks

Results

Intravenous pyelogram

Definition:

An intravenous pyelogram is a type of x-ray examination specifically designed to study the kidneys, bladder, and ureters (the tubes which carry urine from the kidneys to the bladder).

After iodine-based contrast dye is injected intravenously (into a vein), a series of images are taken at timed intervals. The kidneys are responsible for removing contrast dye from the blood and collecting it in urine.

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Abnormalities in the appearance of the kidneys or ureters, distribution of contrast within a kidney, asymmetry in the amount of contrast in each kidney, or defects in the collecting systems can be identified and are suggestive of particular diseases and conditions.

Alternative Names:
Excretory urography; IVP
How the test is performed:

As with other studies, the test is performed in a hospital radiology department or in the health care provider?s office by an x-ray technician. The patient will need to urinate immediately prior the procedure to ensure the bladder is empty, and intravenous access will be placed in a vein of an arm. An initial "scout" image will be taken with the patient lying face-up.

Once the injection of contrast is complete, it is necessary to remain still during the procedure, which may take up to one hour. A compression device (a wide belt containing two balloons that can be inflated) may be used to keep the contrast material in the kidneys.

At the end of the procedure, the patient will again be asked to void for a final image to see how well the bladder has emptied. Usual diet and medications should be resumed after the exam, and adequate hydration is recommended to ensure complete removal of contrast from the blood.

How to prepare for the test:

As with all x-ray procedures, inform the health care provider if you:

Are pregnant
Are allergic to contrast material
Have any drug allergies

You must sign a consent form. Eat a very light dinner or no food the night before the test and do not eat or drink ANYTHING until the test is over (including morning coffee!) You may be given a laxative to take the afternoon before the procedure to remove intestinal gas and feces that could obscure the view of the kidneys. You will put on a gown and remove all jewelry.

Infants and children:

The preparation you can provide for this test depends on your child's age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:

Infant test or procedure preparation (birth to 1 year)
Toddler test or procedure preparation (1 to 3 years)
Preschooler test or procedure preparation (3 to 6 years)
Schoolage test or procedure preparation (6 to 12 years)
Adolescent test or procedure preparation (12 to 18 years)

How the test will feel:

You may be hungry and thirsty from not eating and drinking.
As the dye is injected, there may be a burning or flushing sensation in the arm and the body and a metallic taste in the mouth. This is a normal occurrence and will quickly subside.
Some people develop headaches, nausea, or vomiting after the dye is injected.
The compression device may produce pressure across the abdomen.

Why the test is performed:

The procedure helps evaluate infections in the bladder and the kidneys, blood in the urine, flank pain (which may be from kidney stones), tumors, and evaluates the urinary tract for damage after an abdominal injury.

Recently, computed tomography (CT) has replaced IVP as the primary tool for evaluation of the urinary system since it can be rapidly performed, uses less contrast solution, and provides additional imaging of the abdomen which may reveal other potential sources for the patient's symptoms.