Definition

An intravenous pyelogram (IVP) is a test that uses contrast dye and x-rays to evaluate problems in the urinary tract.

	The Male Urinary System
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Parts of the Body Involved

The urinary tract includes the kidneys, ureters, bladder, and urethra. The intravenous line will be placed in your arm.

Reasons for Procedure

An IVP is done to identify:

• Tumors
• Kidney stones
• Damage to the urinary tract from injury or infection
• Other problems causing kidney malfunction or obstruction (tumor, stone, enlarged prostate )
• Blood in urine

Risk Factors for Complications During the Procedure

• Allergy to contrast dye (ie, iodine)
• Multiple myeloma
• Sickle cell disease
• Pheochromocytoma
• Severely impaired kidney function, which may occur with:
  • Aging
  • High blood pressure
  • Diabetes
  • Heart disease
• Dehydration
• Pregnancy
• Chronic intrinsic kidney disease
• Medications

What to Expect

Prior to Procedure

Preparation for an IVP varies depending on whether it is done as an emergency procedure or on an outpatient basis.

Emergency—Blood is taken for kidney function tests. An intravenous (IV) line inserted. The IV line will provide medication to alleviate pain, nausea, or vomiting. Fluids and the IVP dye are also administered through this IV line. You will lie down and rest before the IVP is done.

Outpatient—in the days leading up to the procedure:

• Blood is taken for kidney function tests.
• The day before, you may be asked to use laxatives and possibly enemas to clean out the colon. This is because stool in the colon may interfere with interpretation of the IVP.
• You will fast for 8 to12 hours before the test.

During Procedure

An IV line providing contrast dye and any other necessary medications is given.

Anesthesia

There is no anesthesia associated with IVP.

Description of the Procedure

Contrast dye is injected into the IV line.

For the next 30 to 60 minutes, you lie on a table while x-rays are taken at regular intervals. You will be asked to hold your breath each time an x-ray is taken.

The dye highlights your urinary system on the x-ray, so your doctor can see these body parts at work and detect problems. Before the last x-ray, you will empty your bladder in a bathroom.

How Long Will It Take?

The procedure typically lasts 60 to 90 minutes.

Will It Hurt?

The procedure is not painful, but you will feel a sensation of warmth or heat as the contrast dye travels through your body.

Possible Complications

• Allergic reaction (rare) manifested as itching or a rash; difficulty breathing or death in severe cases
• Kidney failure (often preventable by evaluating kidney function before the test)

Average Hospital Stay

An IVP is normally an outpatient procedure. However, depending on the reason for the test and the condition of your kidneys, your doctor may recommend a stay in the hospital.

Postoperative Care

Most people can resume normal activities and diet after the IVP is completed. Your doctor will tell you if there are any restrictions you should follow.

Outcome

The results of your IVP test should be available within a few days. Your doctor will discuss the results with you, as well as any necessary treatment.

Call Your Doctor If Any of the Following Occurs

There are no adverse postoperative symptoms associated with IVP.

RESOURCES:

American Urological Association
http://urologyhealth.org

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov/index.htm

CANADIAN RESOURCES:

BC Health Guide
http://www.bchealthguide.org/

The Kidney Foundation of Canada
http://www.kidney.ab.ca

References:

Guide to diagnostic tests. Harvard Health Publications website. Available at: http://www.health.harvard.edu/diagnostic-tests/ .

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