In the article, we will consider what it is - retrograde urography.
With the development of radiology, a lot of methods for diagnosing kidney diseases have arisen. In the middle of the 20th century, thanks to science, X-ray methods were introduced that can reliably study the structure of the genitourinary system. In almost every city, there are currently laboratories that allow for such examinations.
Description
One of the methods of X-ray examination of the genitourinary system is retrograde urography, using a special contrast agent that is installed in the urethra through a catheter. This substance is impervious to x-rays, so it can be clearly seen in the pictures. The method of urography is widely used in the diagnosis of obstruction diseases or defects in the functioning of the genitourinary system. Retrograde urography is characterized by a decrease in the likelihood of allergic reactions due to the non-penetration of contrasting composition into the blood, unlike other types of medical examinations.
Advantages of the method
It is necessary to determine a number of advantages of retrograde urography, which markedly distinguish this technique from other types of studies of the urinary system. Urography allows you to get the best quality information about the degree of inflammation of paired organs, and through the images, the specialist will obtain reliable information about the renal parenchyma, renal pelvis, salt formations, the foci of inflammation are perfectly distinguished in the pictures.
The method is indispensable in determining kidney pathologies and is convenient for determining the degree of the disease. Performing the procedure will not cause inconvenience to the patient and will not cause pain, in addition, the tissues of the urinary system are not injured. This method is widely used for children and adults, does not have serious side effects. In preparation for the procedure, you do not need to take expensive drugs. There is no likelihood of exposure when performing urography, since the doses used are minimal. The method is the most informative and allows you to get the most reliable information.
Indications
There are a number of indications for retrograde urography. It is prescribed for:
- urolithiasis;
- chronic form of pyelonephritis;
- recovery after an intervention on the kidneys;
- blood clots in the urine;
- injuries
- renal colic;
- injuries
- violations of the outflow of urine;
- “Roaming” or drooping kidneys;
- kidney abnormalities.
Retrograde urography is a quick way to get a complete picture of the development of the disease. This technique is carried out urgently for sudden and severe pain in the lower back, which lasts longer than two hours.
Contraindications
The appointment of the procedure is excluded for those patients who have the following diseases:
- adrenal neoplasms;
- an allergic reaction to a contrast medium;
- acute glomerulonephritis;
- internal bleeding;
- thyrotoxicosis;
- hemophilia;
- acute renal failure;
- violation of the outflow of urine.
It is strictly forbidden to carry out urography for women during pregnancy, so as not to affect the body and the child with x-ray radiation. Particularly cautious should be the procedure for patients with insulin-dependent diabetes mellitus, since drugs based on metformin are taken, and it can cause acidosis in reaction with iodine. For such patients, the procedure is performed only while maintaining the allocation function.
In case there are contraindications to the use of urography, the specialist prescribes other diagnostic methods that are not so informative, but will be safe for humans.
Patient preparation
In preparation for retrograde urography using a contrasting composition, certain actions must be performed. It is necessary to refuse several days before the procedure from food products that can cause increased gas formation - carbonated drinks, fresh vegetables, butter baked goods, cabbage.
If there is or is a tendency to flatulence, you should drink a few tablets of activated carbon. What else is preparing the patient for retrograde urography?
Allergic test
Without fail, before the procedure, you need to pass a test for an allergic reaction to a contrasting composition: "Cardiotrust", "Urografin" and "Visipack". If previously there were allergic reactions to the drugs used, it is imperative to tell the specialist about this. Twelve hours before the procedure, you need to eat, during the day you should limit fluid intake, but on the day it is not allowed to eat in the morning. Before the urography, the patient must remove metal products and empty the bladder. To relieve stress, it is advisable to take sedatives.
Retrograde urography technique
The procedure is carried out in a special x-ray room. A contrast composition is chosen before the urography, which does not cause an allergic reaction in the patient and is not toxic.
In the process, a substance that contains iodine is used. The tolerance of the used agent to the patient is established in advance. For these purposes, special tests are carried out. They make a scratch on the skin, apply a drop of iodine to the wound. Twenty minutes later, the patient is examined for a reaction in the form of itching, hyperemia or rash. If one is missing, urography is allowed.
The implementation of the procedure means compliance with exceptional sterility so that infection of the urethra does not occur. The patient is lying down. Then, with the help of a catheter, the renal pelvis is emptied from the urine, a contrast composition filling the kidney and ureter is introduced through the urethra.
Enough of eight milliliters of substance. A person during urography feels heaviness in the lumbar region. If pain occurs in the kidneys, the renal pelvis overflows due to the very rapid intake of excess amounts of the substance. Such violations of the urography technique can cause the appearance of a pelvis-renal reflux.
Pictures are taken while standing and lying down. This approach allows for more volumetric filling with a contrast agent of the pelvis and will make a quality examination. It is advisable to take pictures again an hour after installing the product in order to adequately assess the excretory function of the genitourinary system.
In some cases, this method of diagnosing diseases is called retrograde ureteropyelography in order to more fully interpret the ongoing studies. This procedure is not done when acute inflammation occurs in the urinary system.
Possible side effects
Retrograde urography is a procedure in which the patient does not experience unwanted sensations, a slight discomfort may appear when removing the substance. Side effect of the drug stops after a short time. Before the procedure, the doctor warns the patient about possible unpleasant effects, such as nausea, dizziness, burning, fever and unpleasant aftertaste.
To remove the contrast agent after urography, you need to consume more milk, fresh fruit juices, green tea.
During the procedure, certain complications may appear:
- pelvis-renal reflux ;
- stretching of the pelvis of the kidney;
- an allergic reaction up to the appearance of anaphylactic shock;
- pain in the lumbar region.
If the ureter was damaged, then the contrast medium can enter the kidney tissue, which raises the body temperature. Technical non-compliance with sterility conditions can cause infection. Due to the administration of a contrast agent, acute renal colic may occur.
Reviews of retrograde urography
Patients say that the procedure is unpleasant, but at the same time informative. It is necessary for diagnosis, more effective than ultrasound, and therefore its implementation is justified, despite all the fears.
Sometimes people note complications during manipulations: lower back pain, distension of the pelvis of the kidney, allergic reaction, etc.
Currently, retrograde urography is a highly accurate way to establish the anatomical structure of the organs of the urinary system of a person. Such a procedure simultaneously with cystography is the main study in renal diseases. Urography in itself is not dangerous for the human body if it is done with the non-toxic contrast agent Omnipack. However, you will have to purchase it yourself, since in the conditions of a medical institution it is not provided, it is replaced by other substances.
You must be very careful when the ureter is damaged. If the specialist is incompetent, then the lack of sterility can cause an infectious infection, so it is very important to carry out the procedure in a proven place.
We examined the technique of retrograde urography, indications and contraindications.