The term "excretory urography" refers to a diagnostic method, during which the doctor gets the opportunity to visualize the organs of the urinary system and evaluate their work. The essence of the method is the introduction of a contrast agent into the human body, after which the specialist takes a series of x-rays.
With the help of the obtained images, it is possible to identify pathological processes at an early stage of their development, draw up the most effective treatment regimen, and then evaluate the degree of its effectiveness. Another name for the study is "intravenous urography".
The essence of the method
On a standard x-ray, it is impossible to see and evaluate the functioning of the bladder, duct and pelvis. That is why a contrast agent is injected into the patient's body. Together with the blood flow, it first enters the vessels of the kidneys, and then into the capillaries of the glomeruli. The next step is to filter the radiopaque substance into the urine. Together with urine itenters the pelvis and calyces of the kidneys. The final step is to move it to the bladder, where it is excreted naturally.
Moving through the body, the contrast agent, as it were, illuminates it from the inside. During this, the doctor takes a series of x-rays at regular intervals.
On the images, the structures filled with a contrast agent are white. Thanks to this, the doctor is able to visualize the organs and identify the slightest pathological changes in them.
Indications
Intravenous (excretory) urography is prescribed in the following cases:
- When it is necessary to assess the degree of patency of the ureter. In the process of conducting the study, it is possible to detect stones that impede the outflow of urine.
- To check the integrity of the urinary tract. This is usually required after surgery or injury.
- For the purpose of diagnosing anomalies in the development of organs.
- When to determine the cause of hematuria.
In addition, excretory urography is advisable in case of frequent occurrence of infectious pathologies of the urinary tract in a patient, if a tumor process is suspected, and also if a person has constant pain in the lumbar region.
What reveals
In the process of conducting the study, the doctor gets the opportunity to assess the degree of functioning of the urinary organssystems. In addition, the presence of congenital developmental anomalies is confirmed or excluded, calculi, cysts, and tumors are detected.
Also, excretory urography can detect tuberculosis, hydronephrosis, prostate adenoma.
Features of preparation
Before the study, you need to follow certain rules for some time. Preparation for excretory urography is necessary in order for the results to be as reliable and informative as possible. In addition, following all recommendations minimizes the risk of complications after the procedure.
Preparation for excretory urography of the kidneys, bladder and ducts requires the patient to complete the following steps:
- 3 days before the study, you need to make adjustments to your diet. From the menu you need to exclude products, the use of which leads to excessive gas formation. These include: legumes, rye bread, fresh fruits and vegetables, confectionery and pastries, milk, spirits.
- If the patient has a tendency to increased gas formation, 3 days before the procedure, he must take activated charcoal. It is necessary to follow the dosing regimen specified in the instructions for the drug.
- During the day it is recommended to limit (but not eliminate) fluid intake. The last meal should take place 8 hours before the excretory urography.
- If the patient has problems with bowel movements, it is necessary to give him a cleansing enema the day before, the volume of which should be small. procedurecan be done in the morning on the day of the study. Additionally, before going to bed, it is allowed to take a laxative, for example, Fortrans or Duphalac.
- Immediately before the excretory urography of the kidneys and other organs of the urinary system, it is forbidden to eat any food. If you feel worse due to hunger, you can drink up to 200 ml of weak tea without sugar.
- For some patients, thoughts about the upcoming procedure cause psychological discomfort. In such situations, it is recommended to take a mild sedative. As a rule, doctors prescribe herbal preparations, for example, Persen or Novo-Passit.
- It is necessary to notify the specialist in advance regarding the intake of any medications. In addition, if there is a tendency to allergic reactions, he must also be informed about this. Immediately before the study, you should check with the doctor if there are funds in the office to eliminate acute complications.
During the excretory urography, the patient should not be wearing metal jewelry. For convenience, it is recommended not to wear them at all.
Algorithm for carrying out
In most cases, the diagnostic procedure is standard. However, sometimes the doctor can make adjustments to it. It depends on the individual characteristics of each researcher.
The procedure is carried out in several stages:
- Preparing the patient for excretory urography. The person needs to empty their bladder. In the presence ofmetal objects he needs to remove them. In some cases, the patient is offered to change into a medical gown. After that, the person is placed on the couch of the X-ray unit. The doctor then takes a standard panoramic X-ray.
- Obtaining a contrast agent by the body. Initially, the patient is given a test dose of 1 ml. This need is due to the fact that it is necessary to monitor the body's reaction to the drug, since in some cases adverse reactions may occur. Wait up to 10 minutes after administering the test dose. If no side effects develop after this time, the doctor proceeds directly to the procedure.
- The patient is in the supine position. He is not recommended to move throughout the study. In some cases, multiple shots are taken with the patient in a standing position. As a rule, this is necessary to confirm or rule out kidney prolapse.
- Administration of the main dose of contrast agent. The process takes several minutes (at least 3). The dosage is calculated by the doctor, it depends on the body weight of the patient. During the administration of the drug, the patient may feel slightly worse. It is normal if a metallic taste appears in the oral cavity, there is fever, dizziness, nausea.
- Taking pictures. The doctor takes several images at regular intervals. The first - at 5-7 minutes, when the substance enters the renal pelvis. The second and third shots are taken at 15 and 25 minutes, respectively. In some cases, it is necessary to make delayedpictures (approximately 1 hour after the start of the study). The number of images may be increased at the physician's discretion.
- The final step is to empty the bladder. In most cases, the color of the urine changes. The patient does not need to worry about this. A change in hue indicates the presence of a contrast agent in the urine.
The duration of the procedure can be from 30 minutes to 1 hour. After it is completed, the patient can begin to perform their daily duties. On this day, it is recommended to give preference to green tea, juices and milk from drinks. Their use speeds up the process of removing the radiopaque substance from the body.
Possible Complications
The occurrence of various side effects associated with the administration of the drug. Possible complications:
- An allergic reaction that can manifest itself as a mild rash or anaphylactic shock.
- Acute kidney failure.
- Soft tissue infiltration. May occur when the contrast medium is not completely delivered to the vein.
The X-ray room is equipped with all the necessary medicines to help stop unwanted processes.
Contraindications
Like any other instrumental study, X-ray with contrast has a number of limitations to its implementation. Main contraindications for excretory urography:
- Ureteral obstruction.
- Abdominal aortic aneurysm, presenceneoplasms in this zone.
- Painful sensations of an acute nature in the abdomen.
- In the recent past, abdominal surgery was performed.
- Kidney transplant.
- Allergy to iodine.
- Infectious pathologies during an exacerbation.
- Diabetes mellitus.
- Impaired circulation and clotting process.
- Tuberculosis.
- Acute glomerulonephritis.
- Hyperthyroidism.
- Sepsis.
The study is also not available for people who are in shock or have lost a lot of blood.
Peculiarities of conducting in children
The procedure for the procedure for babies is standard. However, in addition, children are shown a preliminary intake of antihistamines. The choice of contrast by the doctor is carried out more carefully to minimize possible risks. The duration of the procedure in children is less. This is due to the fact that it is almost impossible to make them lie still.
Where to study
Excretory urography can be done both in a budgetary medical institution and in a private clinic. In the first case, you must first obtain a referral from a therapist. In the second, just call the registry of the selected institution and select the most suitable date.
Cost
In Moscow, the minimum price for a study is 2,500 rubles. In some clinics, the cost is many times higher and reaches 10,000 rubles. price directlydepends on the contrast agent used.
In conclusion
The term "excretory urography" refers to a diagnostic method related to radiological. It is prescribed for suspected pathologies of the kidneys, bladder and ducts. The procedure is relatively safe. Side effects occur in isolated cases, as a rule, their appearance is associated with the introduction of a contrast agent.
