- intravenous pyelography
- excretory urogram
An intravenous pyelogram (IVP) is a test that uses x-rays to look at the structure and function of the kidneys, the bladder, and the tubes known as ureters that connect the kidneys to the bladder.
Who is a candidate for the test?
Reasons for having an intravenous pyelogram include:
- blood in the urine
- pain in the mid or lower back
- pain in the abdomen
- injury to the kidneys
- suspicion of cancer
- mass in the abdomen
- high blood pressure
- postoperative follow-up
How is the test performed?
Before having the test, the individual needs to undress completely and put on an exam gown. He or she will lie on the x-ray table facing up. The technologist will take a "scout" film, which is an x-ray taken to identify exactly where the kidneys and bladder are located.
A large dose of contrast material, a dye usually containing iodine, is injected into a vein in the arm. Six or seven more x-rays are usually taken, in a particular order depending on the problem being investigated. Sometimes an additional imaging technique may be used that views the kidney in slices like bread, which is called a kidney tomogram.
Toward the end of the session, the person empties his or her bladder. A final picture is taken is taken after urination. When the test is performed on children or pregnant women fewer films are taken, in order to minimize radiation exposure. The technologist will look at the pictures. If they are satisfactory, the person is free to leave.
What is involved in preparation for the test?
The night before the test, the person will be asked to take 8 ounces of citrate of magnesia. This helps empty the bowel so that the urinary structures will show up better on the x-ray. The individual should not eat within 4 hours or drink within 2 hours of the exam.
Upon reaching the hospital, the person will need to remove all jewelry and metal objects. Individuals are required to sign a consent form that asks about pregnancy and allergies, especially to iodine.
Right before the test, the person will empty his or her bladder. Preparation may vary slightly from place to place, so an individual should check with the healthcare professionals for specific instructions.
What do the test results mean?
The x-ray pictures can show:
abnormal calcifications, a hardening of tissue because of calcium deposits
blockages of the ureters
tumors, either cancerous or non-cancerous
abnormalities of kidneys that are the source of high blood pressure
structural abnormalities that have been present from birth
an enlarged prostate in a man
- changes in urinary system anatomy from previous surgery
Together with the medical history, physical exam, and laboratory results, the IVP helps the healthcare professional decide whether the problem(s) can be managed with medication, or if surgery is needed.