An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
When contrast material is injected into a vein in the patient's arm, it travels through the blood stream and collects in the kidneys and urinary tract, turning these areas bright white on the x-ray images. An IVP allows the radiologist to view and assess the anatomy and function of the kidneys, ureters and the bladder.
What are some common uses of the procedure?
An intravenous pyelogram examination helps the radiologist assess abnormalities in the urinary system, as well as how quickly and efficiently the patient's system is able to handle fluid waste.
The exam is used to help diagnose symptoms such as blood in the urine or pain in the side or lower back.
The IVP exam can enable the radiologist to detect problems within the urinary tract resulting from:
- kidney stones
- enlarged prostate
- tumors in the kidney, ureters or urinary bladder
- scarring from urinary tract infection
- surgery on the urinary tract
- congenital anomalies of the urinary tract
How should I prepare?
Your doctor will give you detailed instructions on how to prepare for your IVP study.
You will likely be instructed not to eat or drink after midnight on the night before your exam. You may also be asked to take a mild laxatives (in either pill or liquid form) the evening before the procedure.
You should inform your physician of any medications being taken and if there are any allergies, especially to iodinated contrast material . Also inform your doctor about recent illnesses or other medical conditions.
You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.
What does the equipment look like?
The equipment typically used for this examination consists of a radiographic table, one or two x-ray tubes and a television-like monitor that is located in the examining room. Fluoroscopy, which converts x-rays into video images, is used to watch and guide progress of the procedure. The video is produced by the x-ray machine and a detector that is suspended over a table on which the patient lies.
How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special detector.
In an IVP exam, an iodine-containing contrast material is injected through a vein in the arm. The contrast material then collects in the kidneys, ureters and bladder, sharply defining their appearance in bright white on the x-ray images.
X-ray images are typically stored as digital images in an electronic archive. However, if needed, a hard film copy (similar to a photograph) or a CD-ROM disk can be made. These stored images are easily accessible and may be compared to current or prior x-ray images for diagnosis and disease management.
How is the procedure performed?
This examination is usually done on an outpatient basis.
You will lie on the table and still x-ray images are taken. The contrast material is then injected, usually in a vein in your arm, followed by additional still images. The number of images taken depends on the reason for the examination and your anatomy.
You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologistwill walk behind a wall or into the next room to activate the x-ray machine.
As the contrast material is processed by the kidneys, a series of images is taken to determine the actual size of the kidneys and to image the urinary tract in action as it begins to empty. The technologist may apply a compression band around the body to better visualize the urinary structures.
When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained.
An IVP study is usually completed within an hour. However, because some kidneys function at a slower rate, the exam may last up to four hours.
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