Intravenous Pyelogram (IVP)

Test Overview

An intravenous pyelogram (IVP) is an X-ray test that provides pictures of the kidneys, the bladder, the ureters, and the urethra (urinary tract). An IVP can show the size, shape, and position of the urinary tract, and it can evaluate the collecting system inside the kidneys.

During IVP, a dye called contrast material is injected into a vein in your arm. A series of X-ray pictures is then taken at timed intervals.

IVP is commonly done to identify diseases of the urinary tract, such as kidney stones, tumors, or infection. It is also used to look for problems with the structure of the urinary tract that were present from birth (congenital).

An ultrasound or a computed tomography (CT) scan may be combined with an IVP if more details about the urinary tract are needed. A computed tomography intravenous pyelogram (CT/IVP) is usually done to look for the cause of blood in the urine.

Why It Is Done

An IVP is done to:

• Identify diseases of the urinary tract, such as kidney stones, tumors, or infection.
• Look for problems with the structure of the urinary tract.
• Find the cause of blood in the urine.
• Look for damage to the urinary tract after an injury.
• Find the cause of urinary tract infections that keep coming back.
• Find the cause of ongoing back or flank pain.

How To Prepare

You may need to stop eating and drinking for 8 to 12 hours before the IVP. You also may need to take a laxative the evening before the test (and maybe have an enema the morning of the test) to make sure that your bowels are empty.

If you are breastfeeding, you may want to pump enough breast milk before the test to get through 1 to 2 days of feeding. The contrast material used in this test can get into your breast milk.

Before the IVP, tell your doctor if:

• You are allergic to the iodine dye used as the contrast material for X-ray tests or to anything else that contains iodine.
• You have ever had a serious allergic reaction (anaphylaxis), such as after being stung by a bee or from eating shellfish.

This test is often done in children to see if they may have an abnormal backflow of urine (vesicoureteral reflux). Prepare your child for exams and tests that are needed. Explain them in a simple way. Use positive words as much as possible. Doing so will help your child understand what to expect and can help reduce fears.

How It Is Done

An intravenous pyelogram (IVP) is usually done by a radiology technologist. The IVP pictures are interpreted by a doctor who specializes in interpreting imaging tests (radiologist).

You will need to remove any jewelry that might interfere with the X-ray picture. You will need to take off all or most of your clothes, and you will be given a cloth or paper covering to use during the test. You will be asked to urinate just before the test begins.

During the test

You will lie on your back on an X-ray table. An X-ray picture of your belly will be taken and reviewed by the radiologist before the next part of the test begins.

The injection site on your arm will be cleaned and the contrast material will be injected into a vein on the inside of your elbow. The dye travels through the bloodstream, is filtered out by the kidneys, and passes into the urine. The urine then flows into the tubes (ureters) that lead to the bladder.

X-ray pictures are taken several minutes apart as the dye goes through the urinary tract. Each picture is developed right away. Sometimes more pictures are taken based on earlier ones. You may be asked to turn from side to side or to hold several different positions so the radiologist can take a complete series of X-rays.

During IVP, a compression device may wrapped around your belly to keep the dye in the kidneys. The most common compression device is a wide belt containing two inflated balloons that push in on either side of your belly to block the passage of dye through the ureters. If you have recently had abdominal surgery or have an abdominal disorder, the band will not be used.

A special type of X-ray technique called fluoroscopy may also be used during IVP. During fluoroscopy, a continuous X-ray beam is used to display a moving image on a video monitor.

IVP usually takes about an hour.

After the test

After the test is over, you will need to drink plenty of liquids to help flush the contrast material out of your body.

How long the test takes

The test will take about an hour.

How It Feels

You will feel no discomfort from the X-rays. You may find that the positions you need to hold are uncomfortable.

You will feel a brief sting when the needle is inserted into the vein in your arm. When the contrast material is injected, you may feel slight burning in your arm and flushing throughout your body. You may also notice a salty or metallic taste in your mouth.

The compression belt may feel tight. If it is painful, tell the technologist and ask that it be readjusted.

Risks

There is a risk of damage to cells or tissue from being exposed to radiation, including the small amounts used in CTs, X-rays, and other medical tests. Over time, exposure to radiation may cause cancer and other health problems. But in most cases, the risk of getting cancer from being exposed to small amounts of radiation is low. It is not a reason to avoid these tests for most people.

There is slight risk of having an allergic reaction to the contrast material.

Results

Your doctor may be able to talk to you about some results right away. Complete results are usually ready in 1 to 2 days.

Intravenous pyelogram (IVP)

Normal:	The kidneys, ureters, and bladder are normal in position, size, and shape.
	The contrast material reaches the kidneys in a normal amount of time.
	No blockage can be seen in the kidneys, ureters, or bladder.
	In men, the prostate gland looks normal in position, size, and shape.
Abnormal:	The kidneys, ureters, or bladder may be abnormal in position, size, or shape. A kidney may be absent, or an extra kidney or ureter may be present. The kidneys are too large or too small.
	The contrast material takes longer than normal to reach a kidney.
	An abnormal growth (such as a tumor), one or more cysts, an abscess, or a kidney stone is seen. A kidney is swollen with urine from a blockage such as a tumor or kidney stone.
	Injury to the kidney, ureter, or bladder is seen.
	The kidney contains scarring.
	In men, the prostate gland is too large.