Intravenous pyelogram

An Intravenous Pyelogram (IVP) is a diagnostic imaging procedure used primarily to evaluate the kidneys, ureters, and bladder. It involves the injection of a contrast medium into a patient's vein, followed by a series of X-rays to observe the contrast as it travels through the urinary system.

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An example of an X-ray image from an IVP procedure.

Procedure

The IVP process encompasses the following steps:

• Preparation: The patient may be instructed to follow a special diet or fast for a specific period before the test. Bowel prep, similar to that used for a colonoscopy, may also be required to ensure clear X-ray images.
• Contrast Injection: A contrast medium, often iodine-based, is injected into a vein, usually in the arm.
• X-ray Imaging: As the contrast medium filters through the kidneys and flows down the ureters to the bladder, a series of X-ray images are taken at intervals to monitor its progression and to highlight any abnormalities.

Indications

IVP is typically ordered for:

• Investigating blood in the urine (hematuria)
• Evaluating kidney stones or potential blockages
• Assessing tumors, cysts, or other structural abnormalities
• Investigating recurrent urinary tract infections (UTIs)
• Examining the urinary system pre- or post-surgery

Risks and Precautions

While IVP is generally considered a safe procedure, there are potential risks:

• Allergic Reaction: Some patients might have an allergic reaction to the contrast medium, especially those with an iodine allergy.
• Kidney Damage: In rare cases, the contrast medium can cause kidney damage, particularly in patients with pre-existing kidney conditions.
• Radiation Exposure: Though the radiation exposure during an IVP is minimal, pregnant women are typically advised to avoid the procedure to prevent potential risks to the fetus.

Patients should always inform their healthcare providers of any allergies, existing medical conditions, or if they suspect pregnancy before undergoing an IVP.

Post-Procedure

Post-IVP, patients are usually advised to drink plenty of water to help flush out the contrast medium from the system. It's also common for the urine to have a slight discoloration for a short period after the procedure. Any unusual side effects or reactions should be promptly reported to a healthcare professional.

See Also

• Radiology
• Kidney Stones
• Urinary System
• Contrast Medium

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