Retrograde Pyelography

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Retrograde Pyelography

Like an IVP, retrograde pyelography uses special contrast agent (dye) to produce detailed X-ray pictures of the ureters and kidneys. The difference is that in retrograde pyelography the dye is injected directly into the ureters rather than into a vein. While newer diagnostic technologies have replaced this test for many functions, retrograde pyelography Glossary

retrograde pyelography: Radiographic imaging of the ureters and collecting system of the kidneys by introducing a dye opaque to X-rays by way of urinary catheter. may still yield better definition of the upper urinary tract, particularly the ureter and kidney. Commonly performed when an IVP produces an inadequate image, it also complementscystoscopy while investigating a patient with hematuria or recurrent or suspected cancer. This test is performed in a hospital radiology department or in a health care provider's office by a urologist and is typically carried out under general anesthesia. Cystoscopy is performed and the small catheter is inserted into the opening of the ureter in the bladder. Dye is injected and fluoroscopy is performed to visualize the ureters and kidneys. The entire study can take 15 to 30 minutes and is done on an outpatient basis.

What is a retrograde pyelogram?
A retrograde pyelogram is a type of x-ray that allows visualization of the bladder, ureters, and renal pelvis. Generally, this test is performed during a procedure called cystoscopy - evaluation of the bladder with an endoscope (a long, flexible lighted tube). During a cystoscopy, contrast dye, which helps enhance the x-ray images, can be introduced into the ureters via a catheter.

As the techniques and technology of ultrasound (high-frequency sound waves) and contrast dye have improved, other procedures such as intravenous pyelogram (IVP) and renal ultrasound have become more commonly used than retrograde pyelography. Reasons for the Procedure

A retrograde pyelogram may be used in persons suspected to have an obstruction, such as a tumor, stone, blood clot, or stricture (narrowing) in the kidneys or ureters. It evaluates the lower portion of the ureter to which urine flow is obstructed. A retrograde pyelogram is also used to evaluate placement of a catheter or a ureteral stent - a wire mesh designed to prop open the ureter.

An advantage of the retrograde pyelogram is that it can be performed even if the patient is allergic to contrast dye because a minimal amount of the contrast dye is absorbed by the body (unlike another more common test called an intravenous pyelogram). The procedure may also be performed on persons with impaired kidney function. There may be other reasons for your physician to recommend a retrograde pyelogram. 2

Risks of the Procedure
The amount of radiation used during a retrograde pyelogram is considered minimal. Therefore, the risk for radiation exposure is very low.
If you are pregnant or suspect that you may be pregnant, you should notify your physician. Radiation exposure during pregnancy may lead to birth defects. If contrast dye is used, there is a risk for allergic reaction to the dye. Patients who are allergic to or sensitive to medications, contrast dye, iodine, or shellfish should notify their physician.

Patients with kidney failure or other kidney problems should notify their physician. In some cases, the contrast dye can cause kidney failure, especially if the person is taking Glucophage (a diabetic medication).

Possible complications of retrograde pyelogram include, but are not limited to, sepsis, urinary tract infection, bladder perforation, hemorrhage, nausea, and vomiting. A retrograde pyelogram may be contraindicated for patients experiencing severe dehydration.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure. Certain factors or conditions may interfere...
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