Intravenous pyelogram

Overview:

Intravenous Pyelogram (IVP) is a diagnostic test used to examine the urinary tract by injecting a contrast dye and later viewing the images using an X-ray. It is also called intravenous urogram. Healthcare professionals use this test to see the parts and functioning of the urinary tract. This is mainly used to identify problems associated with the structure and function of the kidneys, ureters, and the urinary bladder. 

By injecting contrast material into the blood vessels, it flows through the renal blood vessels, gets filtered by the collecting system, and is collected in the kidneys and urinary tract. A series of radiographs are taken before the contrast, with the contrast in the body, and after the contrast is eliminated in the body. Using contrast helps the radiologist visualize the area of interest as they appear as bright white images on the radiographs. 

Indications of the procedure:

This diagnostic tool is used when the patient complains of sharp pain in the back, belly, and side of the body and is associated with blood in urine. It is also used when there is cloudy or bad-smelling urine, pain when urinating, or desire to urinate but unable to pass the urine, when there is an associated swelling in feet and infectious signs of fever and chills. 

It is used to identify any congenital disabilities in the urinary tract, Kidney stones, enlarged prostate, cancers or tumors of the kidneys or bladder or ureters, structural defects of the kidney, scars, previous surgeries, narrowing or obstructions of the kidneys, and urinary tract. This intravenous method for visualizing the urinary tract significantly contributed to medicine.

Preparation for the procedure:

Before undergoing the procedure, an individual must inform the healthcare professional of their medications, any allergies, severe reactions to dyes, previous illnesses, and pregnancy. Generally, it is advised not to eat or drink before the procedure, and sometimes, certain medicines like laxatives may also be prescribed. Any jewelry or metal objects on the body should be removed.  IVP is a procedure done on an outpatient basis and generally takes about an hour. However, in case of severe kidney or other urinary tract problems, it may take more than an hour. 

During the Procedure:

Healthcare professionals may note primary vital data like blood pressure, heart rate, and body temperature. An IV line is placed on the arm after emptying the bladder. This procedure can be done on an outpatient basis. The patient is asked to lie on the back of the examination table. Images are taken using an X-ray machine before injecting the dye. 

Then, a contrast dye is injected through the IV line, and X-ray images are taken regularly as the dye flows through the kidneys, ureters, and bladder. Sometimes, compression may be given to the bladder, and patients are asked to move at different angles to take X-rays. Then, another X-ray image is taken after emptying the bladder. Then, the IV line is removed, and the patient can resume normal activities. 

After the procedure:

The recovery time is minimal and depends on the individual. Most of the time, individuals are advised to take a lot of fluids to flush the dye from the body in urine. 

Benefits of IVP:

IVP is a minimally invasive procedure. It has the advantage of imaging the entire urinary tract and provides valuable and detailed information on the following:

• The size, Position, and symmetry of the kidneys, any thickenings or distortions in the kidney layers, and any abnormalities in the inner and outer structure of the kidneys. 
• Any symmetry, deviations, dilatations, and obstruction in ureters. 
• Position, distention, thickenings, irregularities, abnormalities, and urinary bladder tumors. 

Interpretation of the procedure:

The radiologist and the physician interpret the results. Average results indicate that parts of the urinary tract function well without structural or functional abnormalities. Abnormal results indicate some structural or functional abnormalities, which the physician explains after visualizing the X-rays. 

Side-effects of the procedures:

IVP is generally safe and is associated with mild side effects like stinging due to the placement of an IV line in the arm, warmth or flushing feeling during dye injection, metallic taste in the mouth after the dye injection, nausea, and itching sensation can be seen. 

The amount of radiation the body gets exposed to during X-rays is generally tiny and within safer limits. 

Complications of the procedures:

Complications associated with the procedure are mainly due to the dye. They may range from dropping of blood pressure, anaphylactic shock-like reaction with complete body reaction, breathing problems, life-threatening symptoms, and cardiac arrest. 

Getting exposed to X-rays during pregnancy may harm the unborn baby. Hence, it is always safe to inform healthcare professionals about pregnancy so that necessary decisions about any other procedure can be made. 

Limitations of IVP:

IVP is not indicated in pregnant women or children. In cases of severe functional deficiency, computed tomography or magnetic resonance imaging is prescribed. 

Conclusion:

Intravenous Pyelogram (IVP) is a valuable diagnostic tool for assessing the functioning and structure of the urinary tract. It helps healthcare professionals identify various abnormalities like kidney stones, tumors, and obstructions. Despite its potential complications and limitations, its minimal invasiveness and relatively quick recovery time make it one of the diagnosis choices for detecting urinary tract issues.