The term "intravenous urography" refers to the X-ray method of diagnosis, during which the patient is injected with a contrast agent. The result of the study is a series of images by which the doctor can identify even the slightest disturbances in the functioning of the urinary system. Another name for this diagnostic method is excretory urography.
The essence of the method
Any violation of the functioning of the organs of the urinary system significantly reduces the quality of human life. With the help of intravenous urography, it is possible to timely detect pathology at an early stage of its development.
The essence of the method is as follows: the patient is injected with a contrast agent, which, spreading through the vessels, inevitably enters the kidneys and bladder. With the help of X-ray equipment, the doctor takes a series of images, the analysis of which allows you to assess the degree of functioning of the organs.
Choice of contrast agent
Before performing intravenous urography, the doctor should find out if the patient has intolerance to certain drugs. This is due to the fact that the safety of the procedure directly depends on the choice of the drug. It should be selected only taking into account the individual characteristics of the patient's he alth.
In addition, the following factors are taken into account when choosing a substance:
- No cumulative effect in body cells.
- Good radiopacity.
- Minimum level of toxicity.
- No effect on metabolic processes.
The duration of the procedure directly depends on the properties of the contrast agent. If the substance is able to stay in the body for a long time, the number of X-ray images increases, which significantly increases the degree of diagnostic information. In the process of intravenous urography of the kidneys and other parts of the urinary tract, the doctor gets the opportunity to evaluate not only the functioning of the organs, but also analyze their morphological features.
What allows you to discover?
The contrast agent, penetrating into the circulatory system, enters the renal pelvis after about 7 minutes. Gradually, they, as well as the urethra, are completely filled with the drug. 21 minutes after injection, the substance enters the bladder.
The contrast images obtained as a result of the study allow us to analyze the anatomical structure of the organs of the urinary system, andalso evaluate the excretory function of the kidneys. Due to this, it is possible to timely detect any pathological process at the earliest stage of its development.
Indications
Intravenous urography of the kidneys and other organs of the urinary system is prescribed by a doctor if the patient has the following symptoms:
- Impurity of blood in urine.
- Regular pain in the abdomen and lower back.
- Change in color and smell of urine.
- High blood pressure.
- Impaired urination.
In addition, the following diseases and conditions are indications for intravenous urography:
- Pathologies of the kidneys.
- Injuries of the urinary system.
- Pyelonephritis.
- Anomalies in the structure of the urinary organs.
- Monitoring the effectiveness of surgical intervention.
- Chronic urinary tract diseases.
- Renal colic.
- Neoplasms of both benign and malignant nature.
- Urinary incontinence.
- Kidney mobility.
- Hypertension.
The study is also being conducted to clarify the diagnosis made during the ultrasound.
Contraindications
Intravenous urography, like any other research method, is not performed in the presence of certain diseases and conditions.
The procedure is notassigned at:
- renal failure (both acute and chronic);
- pathologies of the respiratory and cardiovascular systems, as well as the liver;
- sepsis;
- bleeding;
- thyrotoxicosis;
- fever;
- pheochromocytoma;
- allergies to contrast agents;
- glomerulonephritis;
- clotting disorders of fluid connective tissue;
- radiation sickness;
- pregnancy;
- breastfeeding.
In addition, intravenous urography is rarely done in the elderly and people taking certain medications for diabetes.
In the presence of the above contraindications, the doctor decides whether to prescribe other diagnostic methods, such as CT or MRI.
Preparation
To obtain the most reliable and informative results, patients should follow the recommendations below before the procedure:
- A few days before the study, donate biomaterial (blood, urine) for a general analysis, do an ultrasound of the urinary system.
- For 2-3 days, it is necessary to exclude from the diet foods that enhance the process of gas formation in the stomach, as well as dishes, the use of which leads to constipation.
- It is recommended to limit the amount of fluid entering the body (no more than 1.2 liters of water in 12 hours) 1 day before the procedure.
- The day before the eventresearch, you must make the last meal no later than 18 hours. Meals should be easily digestible.
- In the evening before intravenous urography, a small amount (1-3 ml) of a contrast agent is injected into the patient. After that, control over his well-being is carried out. If there is a high risk of an allergic reaction, the patient should start taking antihistamines a few days before the procedure.
- In the evening before the examination, the patient is given a cleansing enema.
- It is advisable to undergo the procedure on an empty stomach. Drinking water should also be excluded or limited to a minimum.
In children, preparation for intravenous urography is similar.
Algorithm for the procedure
Immediately before the examination, the doctor once again examines the patient to identify possible contraindications. In addition, the specialist clarifies whether he followed the rules for preparing for intravenous urography of the kidneys and other urinary organs.
The study is carried out in the X-ray room according to the following algorithm:
- The patient is laid down on the couch. After placing protective devices on his body, the doctor takes a series of standard pictures.
- Then, the patient is injected with a contrast agent (usually into a vein located in the crook of the elbow). The drug is harmless, but when it enters the bloodstream, discomfort may occur. In this regard, the substance is administered very slowly (inwithin 2-3 minutes). At the same time, the patient's well-being is monitored.
- After about 5-10 minutes, several x-rays are taken. The procedure is repeated with observance of certain time intervals, which are determined by the doctor, taking into account the individual characteristics of the patient's he alth.
- In order to assess the dynamics of the functioning of the kidneys, as well as their mobility, another stage of the study may be required. It involves taking a series of images, about an hour after the injection of a contrast agent. In addition, the doctor may refer the patient to an x-ray in a standing position.
The procedure is not associated with the occurrence of pain. A slight discomfort may be felt only when the needle is inserted into the vein. In addition, with proper preparation of the patient for intravenous urography, various complications rarely occur. However, there are always first aid supplies in the X-ray room in case of an emergency.
Possible Complications
Proper preparation is the key to the safety of the procedure. But in isolated cases, the following consequences may be observed:
- Metallic taste in mouth. This condition occurs immediately after the completion of the study and is of a short duration.
- Rash on various parts of the body, indicating the development of an allergic reaction.
- Thirst, dry mouth. These states appear at the end of the procedure and have a pronouncedcharacter.
- Puffiness of the lips. This complication after intravenous urography is extremely rare.
- Tachycardia. A pathological condition characterized by increased heart rate develops in response to the intake of a contrast agent. Tachycardia is of short duration. It disappears rather quickly, and the patient notes the normalization of the heart rate.
- Low blood pressure. A similar state occurs already in the process of conducting the study and persists for some time after its completion.
- Liver failure. Pathology is an extremely dangerous and most severe consequence of intravenous urography. Its occurrence is almost impossible to predict. This is due to the fact that cases have been recorded when failure occurred in patients who had never previously had complaints about the functioning of the liver.
Some of the above complications can cause serious harm to the body. In this regard, each patient must understand that the rules for preparing for the procedure must be treated responsibly, following all the recommendations of the attending physician. In addition, you need to apply only to those medical institutions that employ highly qualified specialists. Competent doctors always pay special attention to preparation and tell the patient in advance about how intravenous urography is performed and what sensations to expect during the study and after its completion.
Cost
This indicator depends on the region of residence, the level of the medical institution, the qualifications of specialists and the type of contrast agent used. In Moscow, the cost of one procedure can range from 3,500 to 10,000 rubles. In some metropolitan clinics, the price is even higher. In remote regions, the average cost of intravenous urography is 5,000 rubles.
Reviews
Experts say that the procedure is not associated with the occurrence of severe discomfort. Judging by the reviews, intravenous urography is a study during which some patients experience mild nausea and dizziness during the administration of a contrast agent. It is extremely rare that any complications occur after the procedure is completed. With proper preparation, the risk of side effects is minimized.
In conclusion
Intravenous urography is a diagnostic method that allows you to assess the degree of functioning of the organs of the urinary system. Its essence is as follows: a patient is injected with a contrast agent into a peripheral vessel located on the elbow bend and a series of x-rays are taken at regular intervals. The resulting images give the attending physician the opportunity to detect pathologies of the urinary organs in a timely manner.
