Intravenous Pyelogram - IVP or Intravenous Urogram - IVU

Information for Adult Patients - Intravenous Pyelogram - IVP or Intravenous Urogram - IVU

What is an Intravenous Pyelogram (IVP) or Intravenous Urogram (IVU)?
The kidneys do not show up well on an ordinary X-ray of the abdomen. It may be possible to see the shape of each kidney, and it will probably be possible to see if any stones are present. However, there is no detail of the internal structure and it is not possible to say how well the kidneys might be working. With an injection of a special dye (called contrast medium), the kidneys show up much better. There is greater detail of their internal structure. It is also possible to assess roughly how well each kidney is working.

Why are there two names for this test?

The test used to be called an Intravenous Pyelogram. Intravenous means the injection is given into a vein. Pyelogram refers to the images produced of the internal structure of the kidneys, the collecting systems, and the tubes leading from the kidneys to the bladder, the ureters. With newer techniques, it is possible to get better detail of the whole of the kidney, and the name was changed to Urogram. However, both names and both abbreviations are used.

Are there any risks?

There are the usual slight risks associated with ionising radiation, and also from the injection of contrast medium. In particular, female patients who are or might be pregnant must inform a member of staff in advance.

All X-ray procedures involve exposure to radiation in varying amounts. We are all exposed to small amounts of radiation from the atmosphere throughout our lives. A large amount of radiation can add slightly to the normal risk of developing cancer. In all X-ray examinations, the amount of radiation is kept to the minimum necessary. However, during an IVP you will be exposed to the same amount of radiation, as you would receive from the atmosphere over a period of about 14 months. Unfortunately, one in three of us are liable to develop a cancer at some stage during our lives, so the added risk from this test is very small indeed. This risk has to be balanced against the possibility of missing a serious disorder by not having the test.

The injection you have for this test is generally very safe. Literally thousands of people have this injection in X-ray departments every day. However, with every injection of the contrast medium, or dye, there is a risk of a reaction. It is not uncommon for people to feel a little warm as the contrast medium flows around the body. Some people may develop a rash, and a few people may get a mild asthma attack. Very, very rarely someone gets a severe allergic reaction, similar to that with, for example, peanut allergy.

The doctors and radiographers in the X-ray department are trained to recognise these reactions, and to treat them. If you have a history of severe reactions to drugs, or have a severe allergy, you may be advised to have a short course of steroid tablets, or an injection, to reduce the risk of a reaction. All risks are relative, and again it is important to remember that the risk of missing a serious problem by not having the test done is much greater.

Are you required to make any special preparations?

Different radiology departments have slightly different arrangements for carrying out this examination. You may be asked not to drink for a few hours beforehand or given a laxative. Please follow the instructions you have been given. If you have any questions, please contact the radiology department. Please also tell the radiology department if you have had a similar examination recently.

If you are diabetic.

If you are receiving treatment for diabetes, please inform the radiology department in advance so that you can be given special instructions about what you should do before and after the IVP.

If you are pregnant.

It is essential that any woman who is pregnant, or might be pregnant, should notify the radiology department in advance. You might not be able to have this examination and some other procedure might have to be adopted.

Can you bring a relative/friend?

Yes, but for reasons of safety, only in special circumstances, or in the case of a young patient, will they be permitted to accompany you into the actual X-ray room.

When you arrive

Please go to the reception desk in the radiology department, after which you will be shown where to wait until collected by a radiographer or other member of staff.

Within the Department the lavatories and public telephones are clearly signposted should you need to use them.

Upon collection

You will be shown to a private cubicle where you may be asked to take off your outer garments. You should place your clothes and valuables in a basket, which you will keep with you. Alternatively, give them to a friend to look after. You may be asked to put on the hospital gown and dressing gown provided, but you may prefer to bring your own dressing gown.

Who will you see?

You will see a radiographer and perhaps a helper. A radiologist or a specially trained radiographer will give you the injection.

What happens during the investigation?

Before you are taken into the X-ray room, you will be asked to visit the lavatory to empty your bladder.

You will then be taken into the X-ray room and asked to lie on the X-ray table. An ordinary X-ray of your abdomen will be taken to start with. This is to look particularly for kidney stones. If stones do show up, one or two other X-rays may be taken. The radiographer may ask you about any allergies or asthma, or whether you have had this test done before. After this you will have the injection of special dye (contrast medium), generally into a vein in your arm near your elbow. You will then have further X-rays taken of your abdomen. Some may be restricted just to the kidney areas, while others will involve your entire abdomen. Most X-rays will be taken with you lying flat on your back, but you may be asked to lie on your stomach for one.

On some occasions, you may have a tight band placed across your abdomen, to improve the detail of your kidneys.

Before the end of the examination you may be asked to go to the lavatory again to empty your bladder.

Will it be uncomfortable?

Having the injection is rather like having blood taken. The needle may hurt briefly while it goes through the skin, but after that you should not feel any pain. While the needle is being inserted, a tourniquet (tight band) may be used to compress your arm, in which case this may feel a little uncomfortable.

How long will it take?

The examinations may be over quickly, especially if everything is normal. However, sometimes the examinations can take longer, particularly if one of the kidneys is not working very well. Generally expect the total time in the department to be at about one hour.

Are there any after effects?

Generally, no. Some people may have a delayed reaction to the injection, for example a rash, but this is very rare.

Can you eat and drink afterwards?

Yes.

When will you get the results?

After the images have been taken, the radiologist, who will prepare a report on the findings, will examine them further. This may take some days to reach your referring doctor but is usually less than a week You should ask the radiologist or Radiographer about timing.

If you have a query?

If you have a query about having the IVP, please ring the Radiology Department between 9am and 5pm, Monday to Friday.

Adapted from a document compiled by the Royal College of Radiologists.