In the article we will consider what it is - retrograde urography.
With the development of radiology, a lot of methods for diagnosing kidney diseases have arisen. In the middle of the 20th century, thanks to science, radiographic methods were introduced that allow you to reliably examine the structure of the genitourinary system. Almost every city now has laboratories that allow such examinations.
Description
One of the methods of X-ray examination of the genitourinary system is retrograde urography, which uses a special contrast agent inserted into the urethra through a catheter. This substance is impervious to x-rays, so it can be clearly seen in the pictures. The method of urography is widely used in diagnosing obstruction diseases or defects in the functioning of the genitourinary system. For retrograde urography, it is characteristicreducing the likelihood of allergic reactions due to non-penetration of the contrast composition into the blood, unlike other types of medical examinations.
Dignity of the method
It is necessary to identify a number of advantages of retrograde urography, which significantly distinguish this technique from other types of study of the urinary system. Urography allows you to get the most qualitative information about the degree of inflammation of paired organs, and through images, a specialist will obtain reliable information about the renal parenchyma, renal pelvis, s alt formations, the foci of inflammation are clearly distinguished in the images.
The method is indispensable in determining the pathologies of the kidneys and is convenient for determining the degree of the disease. The procedure will not cause inconvenience to the patient and will not cause pain, in addition, the tissues of the urinary system are not injured. This method is widely used for children and adults, has no serious side effects. In preparation for the procedure, you do not need to take expensive drugs. There is no possibility of radiation exposure when performing urography, since the doses used are minimal. The method is the most informative and allows you to get the most reliable information.
Indications
There are a number of indications for retrograde urography. It is assigned at:
- urolithiasis;
- chronic form of pyelonephritis;
- recovery after kidney surgery;
- blood clots in urine;
- injuries;
- renal colic;
- injuries;
- Urine outflow disorders;
- "roaming" or drooping kidneys;
- kidney anomalies.
Retrograde urography is a quick way to get a complete picture of the progress of the disease. This technique is performed urgently for sudden and severe pain in the lumbar region that lasts longer than two hours.
Contraindications
The appointment of the procedure is excluded for those patients who have the following diseases:
- adrenal neoplasms;
- allergic reaction to contrast agent;
- acute glomerulonephritis;
- internal bleeding;
- thyrotoxicosis;
- hemophilia;
- acute kidney failure;
- violation of the outflow of urine.
It is strictly forbidden to carry out urography for women during pregnancy, so as not to hit the body and the child with x-rays. Particular care should be taken in patients with insulin-dependent diabetes mellitus, since metformin-based drugs are taken, and it can cause acidosis in reaction with iodine. For such patients, the procedure is carried out only while maintaining the selection function.
If there are contraindications to the use of urography, the specialist prescribes other diagnostic methods that are not so informative, but will be safe for humans.
Patient preparation
When preparing for retrograde urography using a contrast agent, certainactions. It is necessary to refuse a few days before the procedure from foods that can cause increased gas formation - carbonated drinks, fresh vegetables, pastries, cabbage.
If there is or is a tendency to flatulence, you should drink a few tablets of activated charcoal. What else is involved in preparing a patient for retrograde urography?
Allergy test
Without fail, before the procedure, you need to take a test for an allergic reaction to the contrast composition: Cardiotrast, Urografin and Visipak. If you have previously experienced allergic reactions to the products used, you must definitely tell the specialist about it. Twelve hours before the procedure, you need to eat, during the day you should limit fluid intake, but on the day of the procedure you can not eat in the morning. The patient before urography should remove metal products and empty the bladder. To relieve stress, it is advisable to take sedatives.
Retrograde urography technique
The procedure is carried out in a special x-ray room. Choose a contrast agent before urography that will not cause an allergic reaction in the patient and is not toxic.
In the course of the procedure, a substance that contains iodine is used. The tolerance of the used agent by the patient's body is established in advance. For these purposes, special tests are carried out. They make a scratch on the skin, put a drop of iodine on the wound. Twenty minutes later, the patient is examined for the presence of a reaction in the form of itching, hyperemia or rash. If this is not available, urography is allowed.
Under the implementation of the procedure is meant the observance of exceptional sterility, so that infection of the urethra does not occur. The patient is in the supine position. Then, using a catheter, the renal pelvis is emptied of urine, a contrast agent is injected through the urethra, filling the kidney and ureter.
Eight milliliters of the substance is enough. A person during urography feels heaviness in the lumbar region. If there is pain in the kidneys, the renal pelvis overflows due to the very rapid intake of an excess amount of the substance. Such violations of the technique of urography can cause the appearance of pelvic-renal reflux.
Shots are taken in a standing and lying position. This approach enables more voluminous filling of the pelvis with a contrast agent and will make the examination qualitative. It is advisable to take pictures again an hour after the installation of the product in order to adequately assess the excretory function of the genitourinary system.
In some cases, this method of diagnosing diseases is called retrograde ureteropyelography in order to more fully interpret the ongoing research. This procedure is not done in case of acute inflammation processes in the urinary system.
Possible side effects
Retrograde urography is a procedure in which the patient does not experienceundesirable sensations, there may be a slight discomfort when removing the substance. The side effect of the drug stops after a short time. Before the procedure, the doctor must warn the patient about possible unpleasant effects, such as nausea, dizziness, burning, fever and an unpleasant aftertaste.
To remove the contrast agent after urography, you need to consume more milk, fresh fruit juices, green tea.
Certain complications may occur during the procedure:
- pelvic-renal reflux;
- distension of the renal pelvis;
- allergic reaction up to anaphylactic shock;
- pain in the lumbar region.
If the ureter has been damaged, then the contrast agent can enter the kidney tissue, which increases body temperature. Technical non-compliance with the conditions of sterility can cause the appearance of an infectious infection. Acute renal colic may occur due to the injection of a contrast agent.
Retrograde urography reviews
Patients report that the procedure is unpleasant, but informative. It is necessary for diagnosis, more effective than ultrasound, and therefore its implementation is justified, despite all the fears.
Sometimes people report complications during manipulations: lower back pain, distension of the renal pelvis, an allergic reaction, etc.
Currently retrogradeurography is a highly accurate method for establishing the anatomical structure of the organs of the human urinary system. This procedure, along with cystography, is the main study in renal diseases. Urography itself is not dangerous for the human body, if done with a non-toxic contrast agent "Omnipaque". However, you will have to purchase it yourself, since it is not provided in a medical institution, it is replaced by other substances.
You need to be very careful if the ureter is damaged. If the specialist is incompetent, then the lack of sterility can cause infection, so it is very important to carry out the procedure in a verified place.
We reviewed the technique of retrograde urography, indications and contraindications.
