Intravenous Urography Health Article

Description

IVPs are usually done in the morning. In the x ray suite, the patient undresses and lies down. There are two methods of injecting the dye. An intravenous line can be established, through which the dye is consistently fed through the body during the procedure. The other method is to give the dye all at once through a needle that is immediately withdrawn. X rays are taken until the dye has reached the bladder, an interval of half an hour or less. The patient is asked to empty the bladder before one last x ray. A compression device (a wide belt containing 2 balloons that can be inflated) may be used to keep the contrast material in the kidneys. The patient needs to urinate after the compression device is removed. Another picture is taken after the bladder is emptied to see how empty the bladder is.

In the past, of the many ways to obtain images of the urinary system, the intravenous injection of a contrast agent has been considered the best. Recent studies are showing, however, that while intravenous urography is a useful technique, there may be other imaging techniques, such as B mode ultrasound, Doppler ultrasound, renal scintigraphy with angiotensin-converting enzyme inhibitors, intra-venous and intra-arterial catheter angiography, computed tomographic angiography, and magnetic resonance angiography, that are better or less costly.

Preparation

Emptying the bowel with laxatives or enemas prevents bowel shadows from obscuring the details of the urinary system. An empty stomach prevents the complication of vomiting, a rare effect of the contrast agent. Therefore, the night before the IVP the patient is asked to evacuate the bowels and to drink sparingly.

Preparation for infants and children depends on the age of the infant or child.

Aftercare

Feeling weak, nauseous, and/or lightheaded for a short time after the procedure is a possibility.

Risks

Allergy to the contrast agent is the only risk. Anyone with a possible iodine allergy, a previous reaction to x ray dye, or an allergy to shellfish must be particularly careful to inform the x ray personnel.

Exposure to x ray radiation should be noted. Most experts agree that the risk of exposure to low radiation is low compared to the benefits. Pregnant women and children are more sensitive to the risks of x rays.

Normal results

X-ray images of the kidney and bladder structuresappear normal.

Abnormal results

An abnormal intravenous urography result may indicate kidney disease, birth defect, tumor, kidney stone, and/or inflammation caused by infections.

Resources

BOOKS

Ballinger, Philip W., and Eugene D. Frank. Merrill's Atlas of Radiographic Positions and Radiologic Procedures. 9th ed. St. Louis, MO: Year Book Medical Publishers, 1999.

PERIODICALS

Aitchson, F., and A. Page. "Diagnostic Imaging of Renal Artery Stenosis" Journal of Human Hypertension (September 1999): 595-603.

Dalla-Palma, L. "What is Left of I.V. Urography?" European Radiology (March 2001): 931-939.

Hession, P., et al."Intravenous Urography in Urinary Tract Surveillance in Carcinoma of the Bladder." Clinical Radiology (July 1999): 465-467.

Little, M. A., et al."The Diagnostic Yield of Intravenous Urography" Nephrology Dialysis Transplantation (February 2000): 200-204.

ORGANIZATIONS

American Cancer Society (National Headquarters). 1599Clifton Road, N.E., Atlanta, GA 30329. (800) 227-2345. <http://www.cancer.org>.

Cancer Research Institute (National Headquarters). 681 Fifth Avenue, New York, NY 10022. (800) 992-2623. <http://www.cancerresearch.org>.

Kidney Cancer Association. 1234 Sherman Avenue, Suite 203, Evanston, IL 60202-1375. (800) 850-9132. <http://www.kidneycancerassociation.org>.

National Cancer Institute. 9000 Rockville Pike, Building 31, Room 10A16, Bethesda, MD 20892. (800) 422-6237. <http://www.nci.nih.gov>.

National Kidney Cancer Association. 1234 Sherman Avenue, Suite 203, Evanston, IL 60202-1375. (800) 850-9132.

National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. <http://www.kidney.org>.

J. Ricker Polsdorfer, M.D.

Laura Ruth, Ph.D.

Contrast agent

—Any substance that causes shadows on x rays; also known as contrast dye or medium.

Intravenous

—Into a vein.

QUESTIONS TO ASK THE DOCTOR

• What should I feel when I am being imaged?
• Why do you recommend intravenous urography rather than another imaging technique?