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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 taken 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 your arm and body as the contrast dye is injected. You may also have a metallic taste in your mouth. This is 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:
- An abdominal injury
- Bladder and kidney infections
- Blood in the urine
- Flank pain (possibly due to kidney stones)
- Tumors
What Abnormal Results Mean
The test may reveal kidney diseases, birth defects of the urinary system, tumors, kidney stones, or damage to the urinary system.
Risks
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. Most experts feel that the risk is low compared with the benefits.
Children are more sensitive to the risks of radiation. This test is not likely to be done during pregnancy.
Considerations
Computed tomography (CT) scans have replaced IVP as the main tool for checking the urinary system. Magnetic resonance imaging (MRI) is also used to look at the kidneys, ureters, and bladder.
References
Fulgham PF, Bishoff JT. Urinary tract imaging: Basic principles.In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 4.
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School.
