Urography

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Urography
Urography
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Video: Intravenous Urography 2023, February
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Urography

This examination distinguishes between excretory urography and retrograde urography. During the excretory urography, an X-ray contrast image of the kidneys and the lower urinary tract (renal pelvis, ureter and urinary bladder) is performed. With this, not only the tissue structure but also the function of the kidney can be assessed. The retrograde urography mainly reveals obstacles to the flow of urine and reflux of urine into the ureter and kidney.

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  • What is an excretory urography?
  • When is an excretory urography necessary?
  • How does an excretory urography work?
  • What is retrograde urography?
  • When is retrograde urography necessary?
  • How does a retrograde urography work?
  • How are the costs going to be covered?

What is an excretory urography?

Excretory urography (IVU or IVP: abbreviation for intravenous urography or intravenous pyelography) involves an X-ray contrast image of the kidneys and the urinary tract (renal pelvis, ureter and bladder). Through the physiological excretion of intravenously administered X-ray contrast media through the kidneys, their hollow system can be made visible and assessed. With this examination, not only the tissue structure, but also the function of the kidney can be assessed.

When is an excretory urography necessary?

With the help of X-ray contrast imaging of the kidneys and lower urinary tract, the following pathological changes can be detected:

  • congenital and acquired malformations of the kidneys and lower urinary tract,
  • Drainage obstacles (e.g. stones, constrictions, tumors) as well
  • Inflammation (chronic).

In addition, a urography is carried out before a stone is broken up.

For example, the following symptoms may require an examination:

  • Pain in the flanks (colic),
  • Urinary obstruction,
  • Blood in the urine or
  • Fever of unknown cause.

How does an excretory urography work?

The examination is not sober. Only avoid flatulent foods on the day before the examination in order to avoid overlaying the examined region with bloated intestinal loops.

The examination takes place lying down on the X-ray table. First, an image of the abdominal and pelvic region is taken without contrast agent (blank image), since changes such as calcified kidney stones can already be seen here.

A contrast agent is then injected into the arm vein. This reaches the kidneys via the bloodstream and is excreted there via the urinary tract. X-rays of the kidneys and the urinary tract are taken at short intervals to document the excretion of the contrast agent. The entire examination normally takes about 30 minutes, and significantly longer if the urinary tract is obstructed. Afterwards, sufficient fluids should be drunk so that all of the contrast agent is excreted.

What are the side effects / complications?

Excretory urography is a low-risk examination method. Complications and side effects mainly occur in connection with the administration of contrast medium. You can find more information on this under Use of contrast media.

Where is excretory urography performed?

If there is a medical indication for a urography, your attending doctor will issue you with a referral to a hospital with an X-ray unit or to a resident specialist in radiology or to an X-ray institute.

The venous access is provided by a doctor. The X-ray examination is usually carried out by a radiology technologist under the supervision of the doctor. After the images have been created, the radiologist reports.

  • Radiology specialists in your area can be found under Services: Doctor search
  • You can find hospitals (with a radiological department) in your area under Clinic search

What is retrograde urography?

In retrograde urography, obstacles to the flow of urine and reflux of urine into the ureter and kidney are assessed.

When is retrograde urography necessary?

With the retrograde urography of the lower urinary tract, the following pathological changes can be determined:

  • congenital and acquired malformations of the ureter, bladder or urethra,
  • Flow obstacles (e.g. stones, constrictions, tumors),
  • Inflammation of the ureter or urethra as well
  • Injuries and fistulas in the urogenital area.

How does a retrograde urography work?

The patient does not have to be sober. During this examination, the contrast agent is injected directly into the urinary tract to be examined via a catheter. This allows, depending on the placement of the catheter,

  • the renal pelvis,
  • the ureter,
  • the bladder or
  • the urethra will be assessed.

Then x-rays are taken of the region to be examined. In addition, a cystoscope can be inserted into the bladder and advanced into the ureter during this examination.

What are the side effects / complications?

Side effects and complications of this examination are due to the use of contrast media (use of contrast media). In addition, there is a risk of bleeding, infections and injuries that can result from inserting the catheter or the cystoscope. An antibiotic is prescribed for one day to prevent infections.

Where is retrograde urography performed?

Since this examination is carried out in collaboration between specialists in urology and radiology, it is usually carried out in hospitals with a radiological and urological department.

You can find hospitals (with radiological and urological departments) in your area under Clinic search

Note Since urography is an X-ray examination, women must state a possible pregnancy before the examination.

How are the costs going to be covered?

For a urography, you need a doctor's referral. This is valid for one month from the date of issue. The costs are covered by your health insurance provider.

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