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An intravenous pyelogram (IVP) is an X-ray examination of the kidneys, ureters and urinary bladder that is enhanced with iodinated contrast material containing iodine. The contrast material is injected into a patient's vein, and as it passes through the bloodstream, it is collected and excreted by the kidneys. At periodic intervals after the injection, X-rays are obtained of the abdomen. The contrast material is radiopaque, or is readily seen on X-ray, which optimizes visualization of the kidneys, ureters and bladder and allows the radiologist to evaluate anatomy and function.
How should I prepare for the procedure?
You should tell your doctor and the radiology technologist about any known allergies you may have to iodine or intravenous contrast, as well as any medical conditions such as diabetes or kidney disease. Women should always inform their doctor or X-ray technologist if there is any possibility that they may be pregnant.
On the day before the examination:
Between 2 and 4 pm, you must take a laxative, magnesium citrate (or equivalent), 2½ ounces chilled or on ice;
Around 6 pm, limit yourself to a liquid only diet, avoiding fatty liquids such as milk products.
On the day of the examination:
Clear liquids only may be ingested up until two hours prior to the examination;
Nothing by mouth for two hours prior to the examination;
Patients scheduled for afternoon examinations may have a light breakfast (toast, coffee, juice) before 9 am. Again, avoid fatty liquids such as milk products.
How is the procedure performed?
The patient will be positioned on an X-ray table and a preliminary "plain film" X-ray will be taken of the abdomen. Subsequently, iodinated contrast material is injected into a vein, usually in the patient's arm. Multiple X-ray images are taken after the injection of the contrast material. During the sequence of X-rays, the technologist may apply a compression band around the abdomen to better visualize the urinary structures. At times, kidneys may not clear the contrast at the same rate, and delayed films from 30 minutes to three or four hours may be requested. However, a typical IVP study takes about an hour.
What will the procedure be like?
Aside from a needle stick for the injection of contrast material, an IVP causes no discomfort. When the contrast material is injected, some patients report feeling a warm sensation and/or a metallic taste in their mouth. These side effects are common and usually pass within a minute or two. Some patients may experience a mild itching sensation, and if it persists or is accompanied by hives, it can be easily treated with medication. In very rare instances, a patient may become short of breath or experience swelling in the throat. This can be an indication of a more serious type of reaction to the contrast material and should be reported immediately to the radiology technician.
During the imaging process, you may be asked to turn from side to side and to hold several different positions to enable the technologist to obtain views from different angles. The technologist may apply a compression band around the abdomen while the X-rays are being taken to better visualize the urinary structures leading from the kidney. Near the end of the examination, you may be asked to void so that an additional film can be taken of your empty bladder. The contrast material used for IVP studies will not discolor your urine or cause any discomfort when you urinate.
