has anyone ever had an ivp done? how long did it take. what does it show different than ultrasounds? i have to have several ultrasounds and an ivp done. Intravenous pyelography refers to a series of x-rays taken of the kidneys, their collecting or drainage system (the ureters), and the bladder.
An intravenous pyelogram (IVP) may be performed to detect a problem of the kidneys, ureters, and bladder. Most often, the IVP is done to locate a suspected obstruction to the flow of urine through the collecting system. The most common cause of blockage is a kidney stone. The IVP test also gives information about the functioning of the kidneys.
In an IVP test, dye is injected via a catheter inserted in a person's vein, usually on the hand or the forearm. X-rays are then taken to follow the track of the dye through the system.
The dyes (also called radio contrast media) are of 2 types: ionic and nonionic. Both types of dye contain iodine but differ in 2 key ways: the rate of adverse reactions and the cost.
Although the overall rate of adverse reactions is relatively low with both, there is a greater incidence of adverse reactions with the less expensive ionic dye than with the nonionic.
Minor reactions, which are infrequent and do not last long, include flushing, nausea, vomiting, and itching.
A small percentage of people experience a severe reaction to the dye, such as difficulty breathing, speaking, or swallowing; swelling of the lips and tongue; low blood pressure; or loss of consciousness. People who have had a severe reaction after receiving the dye once should not be exposed to it again.
Pregnant women should not have an IVP because of the high radiation exposure.
Elderly people and those with diabetes, high blood pressure, heart disease, or evidence of dehydration are at risk of developing kidney failure following administration of the dye.
To avoid this complication, the kidney function should be tested with a blood test of the BUN (blood urea nitrogen) and creatinine, and the results should be known before the IVP is performed.
Those with diabetes and certain others (for example, women with polycystic ovarian syndrome) who are taking metformin (Glucophage) will have to discontinue this medication for 2 days after the IVP. They should inform their doctor of the test, and the doctor will coordinate their management during that time.
Intravenous Pyelogram Preparation
The intravenous pyelogram may be performed as an emergency procedure or on an outpatient basis. In most cases, the IVP becomes an emergency procedure because you might arrive at the emergency department with symptoms (usually pain in the back and abdomen) that suggest a blockage to the flow of urine through the ureter. In this case, there is usually no time to "prepare" the bowel before the test is done.
The emergency department staff will draw blood and start an IV line. The IV will be used to give medication to alleviate pain, nausea, and vomiting and to administer fluids as well as the dye used in the test. Your urine will be tested for abnormalities. While waiting for the IVP to be done, you should be lying down and resting, without any pain or discomfort.
In nonemergency cases, typically you would go to the doctor鈥檚 office with a complaint that suggests a problem with the kidneys, ureters, or bladder. The doctor might believe that an IVP would help in making the diagnosis but may not require that it be done immediately. In that case, you will need to prepare for the test. Preparation will involve the use of laxatives and, in some cases, enemas to cleanse the bowel of stool. Additionally, you are usually asked not to eat for 8-12 hours before the test is done.
During the Procedure
You will go to the x-ray department for the IVP test. While you are lying face up on the x-ray table, dye is injected through an IV placed in a vein.
The x-rays are taken at several intervals, such as at 0, 5, 10, and 20 minutes. Zero time is the time of injection of the dye. The test is completed when the kidneys, ureters, and bladder show up on the x-ray. Although the dye is colorless, it makes the kidneys and ureters appear white on the x-ray so that they contrast with the background of the rest of the abdomen.
If, for example, the kidneys, ureters, and bladder can be seen after the 5-minute film is taken, then one last film will be taken immediately after you have urinated. If only one kidney and its ureter are seen after the 5-, 10-, and 20-minute pictures are taken, then the doctor will decide when further films should be taken. As a general rule, the interval for further films is determined by doubling the time from the last film. The time will be doubled until both kidneys and ureters can be seen.
For example, if only one kidney and its ureter are seen after the 20-minute picture is taken, then the next film will be done 40 minutes later. If the x-ray technician is still unable to see the kidneys after the 40-minute film, then the next test will be taken 80 minutes later.
While you are waiting for the x-rays to be taken, the nurses will check frequently to ensure that you are not experiencing any pain, nausea, or vomiting and, at the same time, will check your blood pressure, pulse, and breathing to make sure that these vital signs remain normal. If you have pain, nausea, or vomiting, the nurse can give appropriate medicines through the IV to help these symptoms.
After the Procedure
After the x-rays are completed for the intravenous pyelogram, the doctor will review the films and discuss the findings with you and family members. If, for example, the doctor is unable to see both kidneys after a 4-hour picture, then you may have to be admitted to the hospital to continue further studies.
The most common cause of obstruction to the flow of urine is a kidney stone. Other causes include masses, tumors, or cancers in adjacent tissues pressing against the ureter. Sometimes, bleeding from the kidney can produce a blood clot that can obstruct urine flow in the ureter. In older men, prostate enlargement can obstruct the flow of urine from the bladder as well as through the ureters.
Following the test, the doctor might propose one of two courses of action: either waiting a few days for the stone to pass in the urine or referring to a urologist鈥攁 surgeon who specializes in diseases of the urinary tract.
Next Steps
If, while waiting for the "stone" to pass, your symptoms worsen over the next 5-7 days, the doctor might order a repeat intravenous pyelogram to determine if the stone has changed location.
If you are waiting to pass a stone, drink a lot of water to generate urine that will flush the stone through the ureters and into the bladder then out. The stone that passes out of the body through the urine can be easily captured if you urinate into a special cup that has a sieve at the bottom. The urine passes through the cup and into the toilet, and the stone (eventually, you hope) is trapped in the cup. Save the stone and take it to your doctor for analysis.
If you are waiting for the "stone" to pass, and the pain worsens or vomiting is frequent enough that you cannot keep down pain medicine or fluids, call the doctor. Other warning signs include fever, chills, and seeing more blood in the urine. I've had a few done, primarily to detect kidney stones. You'll feel a rush as the dye enters your system and begins to circulate. Then you'll become very warm. The medicine might make you feel nauseated, the Dr. might give you some Phenergen to help. The dye helps make blockages easier to see via x-rays. The procedure takes about 30 minutes best I recall.
I don't remember to much, I'd already been given Demoral (aka damn-it-all) for the pain and was in la-la land. |
