Intravenous pyelogram
Excretory urography; IVPAn intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladder).
x-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray waves through the body. The images...
Read Article Now Book Mark ArticleHow the Test is Performed
An IVP is done in a hospital radiology department or a health care provider's office.
You may be asked to take some medicine to clear your bowels before the procedure to provide a better view of the urinary tract. You will need to empty your bladder right before the procedure starts.
Your 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. This is to see how the kidneys remove the dye and how it collects in your urine.
You will need to lie still during the procedure. The test may take up to an hour.
Before the final image is taken, you will be asked to urinate again. This is to see how well the bladder has emptied.
You can go back to your normal diet and medicines 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 provider if you:
- Are allergic to contrast material
- Are pregnant
- Have any drug allergies
- Have kidney disease or diabetes
Your provider will tell you if 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. This will help your kidneys to be seen clearly.
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 go away quickly.
Flushing
Skin blushing or flushing is a sudden reddening of the face, neck, or upper chest due to increased blood flow.
Read Article Now Book Mark ArticleSome 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
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Flank pain (possibly due to kidney stones)
Flank pain
Flank pain is pain in one side of the body between the upper belly area (abdomen) and the back.
Read Article Now Book Mark ArticleKidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
Read Article Now Book Mark Article - 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, a different test can be done. Other tests include retrograde pyelography, MRI, or ultrasound.
Allergic reaction
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
Read Article Now Book Mark ArticleThere 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 generally avoided 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
Bishoff JT, Rastinehad AR. Urinary tract imaging: basic principles of CT, MRI, and plain film imaging. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 3.
Gallagher KM, Hughes J. Urinary tract obstruction. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 58.
Sakhaee K, Moe OW. Urolithiasis. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Taal MW, Skorecki K, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 38.
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Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
Kidney anatomy
illustration
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Kidney - blood and urine flow - illustration
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
Kidney - blood and urine flow
illustration
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Intravenous pyelogram - illustration
An intravenous pyelogram is performed by injecting contrast material into a vein in the arm. A series of x-rays are taken at timed intervals as the contrast material goes through the kidneys, the ureters (the tubes connecting the kidneys to the bladder), and the bladder. The procedure helps to evaluate the condition of the kidneys, ureters, and bladder.
Intravenous pyelogram
illustration
-
Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
Kidney anatomy
illustration
-
Kidney - blood and urine flow - illustration
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
Kidney - blood and urine flow
illustration
-
Intravenous pyelogram - illustration
An intravenous pyelogram is performed by injecting contrast material into a vein in the arm. A series of x-rays are taken at timed intervals as the contrast material goes through the kidneys, the ureters (the tubes connecting the kidneys to the bladder), and the bladder. The procedure helps to evaluate the condition of the kidneys, ureters, and bladder.
Intravenous pyelogram
illustration
Review Date: 1/1/2023
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.