The term "intravenous urography" refers to the x-ray diagnostic method, during which a contrast agent is administered to the patient. The result of the study is a series of images by which the doctor can detect even the smallest disturbances in the functioning of the urinary system. Another name for this diagnostic method is excretory urography.
The essence of the method
Any violation of the functioning of the urinary system significantly reduces the level of quality of life. Using intravenous urography, it is possible to timely detect pathology at an early stage of its development.
The essence of the method is as follows: a contrast drug is administered to the patient, which, spreading through the vessels, inevitably enters the kidneys and bladder. Using X-ray equipment, the doctor takes a series of images, the analysis of which allows you to assess the degree of functioning of the organs.
The choice of contrast medium
Before carrying out intravenous urography, the doctor must find out whether the patient has intolerance to certain drugs. This is due to the fact that the safety of the procedure directly depends on the choice of the drug. It should be selected only taking into account the individual characteristics of the patient's health.
In addition, the following factors are considered when choosing a substance:
- Lack of cumulative effect in the cells of the body.
- Good degree of radiopacity.
- The minimum level of toxicity.
- The absence of any effect on metabolic processes.
The duration of the procedure directly depends on the properties of the contrast drug. If the substance is able to stay in the body for a long time, the number of x-ray images increases, which significantly increases the degree of information content of the diagnosis. In the process of intravenous urography of the kidneys and other parts of the urinary tract, the doctor gets the opportunity to evaluate not only the functioning of the organs, but also analyze their morphological features.
What allows you to detect?
Contrast substance, penetrating the circulatory system, after about 7 minutes enters the renal pelvis. Gradually, they, as well as the urethra, are completely filled with the drug. 21 minutes after administration, the substance enters the bladder.
Contrast images obtained as a result of the study allow us to analyze the anatomical structure of the organs of the urinary system, as well as evaluate the excretory function of the kidneys. Due to this, it is possible to timely detect any pathological process at the earliest stage of its development.
Indications
Intravenous urography of the kidneys and other organs of the urinary system is prescribed by a doctor if the patient has the following symptoms:
- Add blood in urine.
- Regular pain in the abdomen and lower back.
- Change in color and smell of urine.
- High blood pressure.
- Violation of the urination process.
In addition, the following diseases and conditions are indications for intravenous urography:
- Pathology of the kidneys.
- Injuries to the urinary system.
- Pyelonephritis.
- Anomalies in the structure of the urinary organs.
- Monitoring the effectiveness of surgical intervention.
- Diseases of the urinary organs of a chronic nature.
- Renal colic.
- Neoplasms of both benign and malignant nature.
- Urinary incontinence.
- Mobility of the kidneys.
- Arterial hypertension.
The study is also conducted to clarify the diagnosis made during the ultrasound.
Contraindications
Intravenous urography, like any other research method, is not performed in the presence of certain diseases and conditions.
The procedure is not prescribed for:
- renal failure (both acute and chronic);
- pathologies of the organs of the respiratory and cardiovascular systems, as well as the liver;
- sepsis
- bleeding
- thyrotoxicosis;
- fever;
- pheochromocytoma;
- allergies to contrast agents;
- glomerulonephritis;
- coagulation disorders of fluid connective tissue;
- radiation sickness;
- pregnancy
- breastfeeding.
In addition, intravenous urography is rarely performed for the elderly and people taking certain medications for diabetes.
In the presence of the above contraindications, the doctor decides on the advisability of prescribing other diagnostic methods, for example, CT or MRI.
Preparation
To obtain the most reliable and informative results, patients should follow the recommendations below before the procedure:
- A few days before the test, pass the biomaterial (blood, urine) for a general analysis, make an ultrasound of the urinary system.
- For 2-3 days, it is necessary to exclude from the diet foods that enhance the process of gas formation in the stomach, as well as dishes, the use of which leads to constipation.
- 1 day before the procedure, it is recommended to limit the amount of fluid entering the body (not more than 1.2 liters of water in 12 hours).
- The day before the study, it is necessary to make the last meal no later than 18 hours. Dishes should be easily digestible.
- In the evening before intravenous urography, a small amount (1-3 ml) of contrast medium is administered to the patient. After that, control over his well-being is carried out. If there is a high risk of an allergic reaction, the patient should start taking antihistamines a few days before the procedure.
- In the evening, before the examination, the patient is given a cleansing enema.
- It is advisable to undergo the procedure on an empty stomach. Water use should also be eliminated or limited to a minimum.
In children, preparation for intravenous urography is carried out in a similar way.
Procedure Algorithm
Immediately before the study, the doctor will examine the patient again to identify possible contraindications. In addition, the specialist clarifies whether they followed the rules for preparing for intravenous urography of the kidneys and other urinary organs.
The study is carried out in an x-ray room according to the following algorithm:
- The patient is laid on the couch. After placing protective devices on his body, the doctor takes a series of standard pictures.
- Then the patient is injected with a contrast medium (usually in a vein located on the elbow). The drug is harmless, but when it penetrates the bloodstream, discomfort may occur. In this regard, the substance is introduced very slowly (within 2-3 minutes). At the same time, the patient is being monitored.
- After about 5-10 minutes, several x-rays are taken. The procedure is repeated in compliance with certain time intervals, which are determined by the doctor taking into account the individual characteristics of the patient’s health.
- In order to dynamically evaluate the functioning of the kidneys, as well as their mobility, another stage of the study may be required. It involves a series of shots, about an hour later, after the administration of a contrast medium. In addition, the doctor can refer the patient to an X-ray in a standing position.
The procedure is not associated with the occurrence of pain. Slight discomfort can only be felt when the needle is inserted into a vein. In addition, with proper preparation of the patient for intravenous urography, various complications rarely arise. Nevertheless, in the X-ray room there are always first-aid equipment in case of unforeseen situations.
Possible complications
Proper preparation is the key to the safety of the procedure. But in isolated cases, the following consequences can be observed:
- Metallic taste in the mouth. This condition occurs immediately after the completion of the study and is of short duration.
- A rash in various parts of the body, indicating the development of an allergic reaction.
- Thirst, dry mouth. These conditions appear at the end of the procedure and are pronounced.
- Swelling of the lips. A similar complication after intravenous urography is extremely rare.
- Tachycardia. A pathological condition characterized by an increase in heart rate develops in response to the intake of a contrasting drug. Tachycardia is short-lived. It disappears quite quickly, and the patient notes the normalization of the heart rhythm.
- Low blood pressure. A similar condition occurs already in the process of conducting the study and persists for some time after its completion.
- Liver failure. Pathology is an extremely dangerous and most severe consequence of intravenous urography. Its occurrence is almost impossible to predict. This is due to the fact that cases have been recorded when insufficiency arose in patients who had never before had complaints about the functioning of the liver.
Some of the above complications can cause serious harm to the body. In this regard, each patient should understand that the rules of preparation for the procedure must be treated responsibly, following all the recommendations of the attending physician. In addition, you need to contact only those medical institutions in which highly qualified specialists work. Competent doctors always pay special attention to preparation and tell the patient in advance how intravenous urography is performed and what sensations to expect during the study and after it is completed.
Cost
This indicator depends on the region of residence, the level of the medical institution, the qualifications of specialists and the type of contrast medium used. In Moscow, the cost of one procedure can be from 3,500 to 10,000 rubles. In some metropolitan clinics, the price is even higher. In remote regions, the average cost of intravenous urography is 5,000 rubles.
Reviews
Experts say that the procedure is not associated with the occurrence of severe discomfort. Judging by the reviews, intravenous urography is a study during which some patients experience slight nausea and dizziness during the administration of a contrast medium. Very rarely, after the completion of the procedure, any complications arise. With proper preparation, the risk of side effects is minimized.
Finally
Intravenous urography is a diagnostic method that allows you to assess the degree of functioning of the urinary system. Its essence is as follows: a contrast agent is injected into the patient in a peripheral vessel located on the elbow, and a series of x-rays are taken at regular intervals. The obtained images give the attending physician the opportunity to timely detect pathologies of the urinary organs.