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Kidney anatomy
Kidney anatomy


Kidney - blood and urine flow
Kidney - blood and urine flow


Intravenous pyelogram
Intravenous pyelogram


Definition:

An intravenous pyelogram (IVP) is a special x-ray examination of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladder).



Alternative Names:

Excretory urography; IVP



How the test is performed:

An IVP is done in a hospital radiology department or a health care provider’s office by an x-ray technician.

You will need to empty your bladder immediately before the procedure starts.

The health care provider will inject an iodine-based contrast (dye) into a vein in your arm. A series of x-ray images are takened at different times to see how the kidneys remove the dye and how it collects in your urine.

A compression device (a wide belt containing two balloons that can be inflated) may be used to keep the contrast material in the kidneys.

You will need to remain still during the procedure, which may take up to an hour.

Before the final image is taken, you will be asked to urinate again, to see how well the bladder has emptied.

You can resume your normal diet and medications after the procedure. You should drink plenty of fluids to help remove all the contrast dye from your body.



How to prepare for the test:

As with all x-ray procedures, tell your health care provider if you:

  • Are allergic to contrast material
  • Are pregnant
  • Have any drug allergies

Your health care provider will tell you whether you can eat or drink before this test. You may be given a laxative to take the afternoon before the procedure to clear the intestines so your kidneys can be clearly seen.

You must sign a consent form. You will be asked to wear a hospital gown and to remove all jewelry.



How the test will feel:

You may feel a burning or flushing sensation in the arm and body as the contrast dye is injected. You may also have a metallic taste in the mouth. This is a normal and will quickly disappear.

Some people develop a headache, nausea, or vomiting after the dye is injected.

The belt across the kidneys may feel tight over your belly area.



Why the test is performed:

An IVP can be used to evaluate:

  • Bladder and kidney infections
  • Blood in the urine
  • Flank pain (possibly due to kidney stones )
  • Tumors
  • The urinary tract for damage after an abdominal injury


Normal Values:



What the risks are:

There is a chance of an allergic reaction to the dye, even if you have received contrast dye in the past without any problem. If you have a known allergy to iodine-based contrast, an alternate test should be performed. Alternatives include retrograde pyelography, MRI, or ultrasound.

There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits.

Pregnant women and children are more sensitive to the risks of radiation.



Special considerations:

Computed tomography (CT) scans has replaced IVP as the main tool for checking the urinary system. CT takes less time to perform and provides additional views of the abdomen, which can help rule out other possible reasons for the patient's symptoms. Magnetic resonance imaging (MRI) is also used to look at the kidneys, ureters, and bladder.



References:

Norrby SR. Approach to the patient with urinary tract infection. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 306.




Review Date: 10/2/2008
Reviewed By: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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