What Is an Intravenous Pyelogram?
An intravenous pyelogram (IVP) is a type of X-ray that looks at your kidneys and bladder and the ducts (ureters) that connect them. Doctors don’t use it very often. Other imaging tests, like CT scans, are more common.
Intravenous Pyelogram Purpose
This test lets your doctor see the size and shape of your bladder, kidneys, and ureters, and how well they’re working. They can spot blockages in your urinary tract caused by:
- Kidney stones
- Enlarged prostate
- Tumors in the kidney, ureters, or bladder
- Kidney cysts
- Scarring, either from surgery or a urinary tract infection
- Congenital problems in the urinary tract, such as medullary sponge kidney.
IVP images can give your doctor enough detailed information to treat a blockage with medication. Otherwise, you may need surgery. While IVP used to be the go-to procedure for diagnosing urinary tract problems, it’s largely been replaced by ultrasound and CT scans.
An intravenous pyelogram isn’t a good choice for everyone. Don’t get the procedure if:
- You’re allergic to iodine or contrast dye.
- You have kidney disease.
- You’re pregnant or may be pregnant. Your doctor will most likely choose a different test, because X-rays use a small burst of radiation.
- Infants and children rarely get IVPs.
Intravenous Pyelogram Preparation
Before you have the test, let your doctor know if you’re pregnant or have any medical conditions, if you have allergies, and if you’re taking any prescription or over-the-counter medicines.
If you take any of these, you might need to stop before your procedure:
The doctor may ask you to take mild laxative the night before the IVP and tell you not to eat or drink after midnight.
You also may need a blood test to see how your kidneys will react to the contrast dye.
Intravenous Pyelogram Procedure
You’ll probably change into a hospital gown.
A lab technician will inject a liquid called a contrast material into your hand or arm through an IV. The dye travels through your bloodstream to your kidneys and urinary tract.
You’ll lie still on a table as the tech takes the X-rays. You may be asked to turn from side to side and hold different positions.
The IVP shows the urinary tract in action as your kidney begins to empty into the ureters. These are the tubes that carry urine to the bladder. The iodine will show up as bright white on the film. Dye that doesn’t move or moves too slowly shows where the blockages are. The images also may show that your kidney, bladder, or ureter isn’t working as well as it should.
Near the end of the exam, you’ll be asked to pee. This lets your radiologist get a picture of your bladder after it empties.
An IVP usually takes less than 1 hour. If your kidneys work more slowly, the test can last up to 4 hours. You should be able to go back to your normal diet and activities afterward. The doctor may tell you to drink more fluids than normal to flush the contrast dye from your body.
Intravenous Pyelogram Risks
Most of the time, an intravenous pyelogram is safe with no complications. But there are side effects and some risks.
- You’ll feel a sting as the technician injects the contrast material into your hand or arm.
- You may feel itchy or become flushed as the contrast material moves through your body.
- You might have a salty or metallic taste in your mouth.
- You could have a brief headache.
- You may feel nauseated.
These side effects are common and normally go away within a couple of minutes.
In rare cases, you may have an allergic reaction to the contrast material, or dye. That will cause:
These symptoms can be treated with medication.
It’s less common, but possible, to have a serious allergic reaction. That can cause:
- Shortness of breath
- Swelling in your throat or elsewhere
- Low blood pressure
- Cardiac arrest
Tell your radiologist right away if you have any symptoms.
You’re more likely to have an allergic reaction to the dye if you have:
If you have kidney disease, there’s a chance the contrast material, or dye, could cause further kidney damage.
As with any X-ray, your body is exposed to radiation that can cause cancer. But the level is low in an IVP.
Intravenous Pyelogram Results
A radiologist will analyze the images and send a report to your doctor, who’ll share the results with you.
Abnormal results could mean you have:
- Kidney stones
- Enlarged prostate
- Tumor or cyst in your urinary tract
- Structural problems with your kidneys, bladder, or ureters
- Scarring or other damage in your urinary tract
You may need other exams and a follow-up visit to see if your treatment is working.