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Intravenous Pyelogram (IVP)

Historically, before the introduction and widespread adoption of computed tomography (CT) imaging, the intravenous pyelogram, or IVP, was the most commonly utilized radiographic study of the urinary tract. The IVP is an x-ray test in which a contrast agent (also termed "x-ray dye") is injected into a patient's vein; the contrast agent acts to outline the patient's kidneys, ureters, and bladder when x-rays are subsequently taken. Doctors would order an IVP for a number of reasons, including the evaluation of pain in their side, blood in the urine (hematuria), or other stone-related symptoms. In the present day, though, IVP is becoming less and less used (although there are still certain cases where it may be a helpful study), primarily as a result of the introduction of CT imaging. CT has become the x-ray study of choice for the evaluation of the urinary tract, because it can rapidly (even in a single breath-hold) image the entirety of the urinary tract. Since a CT scan presents its images as a cross-sectional view of the patient, oftentimes CT provides a greater amount of information than an IVP does, making CT a more cost-effective study. Furthermore, in many cases a CT imaging study does not require the administration of a contrast agent.

An IVP is generally performed in a hospital radiology department or a physician's office by an X-ray technologist and under the supervision of a radiologist or urologist. The patient will commonly be placed on a restricted diet 24 hours prior to the test and will be asked to urinate immediately prior to the test to ensure that the bladder is empty. The patient will then be asked to lie on their back and to remain still. A preliminary film, also called a "scout" film, of the abdomen and pelvis is obtained prior to the administration of intravenous contrast. The preliminary film ensures that the x-ray machine is calibrated correctly for the patient's size, and that there are no small stones present. Following intravenous injection of the contrast agent, a series of x-rays will be obtained, following the contrast material as it filters through the kidneys. Once the agent has filtered through the kidneys, it will pass down the ureters and into the bladder. Again, x-rays are obtained throughout this process, following the course of the contrast agent. The x-rays will be reviewed for evidence of tumors, cysts, stones or other structural and functional abnormalities.

At the conclusion of the study, the patient will be asked to urinate, so that a final set of images can be obtained to document how well the bladder empties. Once the IVP is over, the patient can immediately resume their daily activities.

The primary risk of an IVP test is a reaction to the x-ray dye. Such reactions are not common, but do occur in anywhere from 3 to 13 percent of people undergoing an IVP. In general, reactions are minor, and consist of symptoms such as flushing, nausea, or vomiting. These minor effects are usually treated successfully with medications such as antihistamines (drugs that reduce the effects of the body's inflammatory compound, histamine). In very rare circumstances, more severe complications—breathing difficulties, low blood pressure, swelling of the mouth or throat and even cardiac arrest—can occur.

Patients with certain health factors—a history of allergic reactions such as hay fever, asthma or hives, as well as congestive heart failure, and diabetes—may be at greater risk for reactions to the x-ray dye. In these situations, administering antihistamines or steroids prior to the exam will reduce the risk of a reaction to the x-ray dye. In addition, modern contrast agents, termed non-ionic contrast agents, are associated with a reduced risk of an allergic response.

An IVP is associated with a relatively low radiation exposure to the patient. However, a patient who is or may be pregnant should notify their physician prior to this examination as a fetus can be more susceptible to the risks associated with radiation.

Reviewed January 2011

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Intravenous Pyelogram (IVP) Glossary
  • abdomen: Also referred to as the belly. It is the part of the body that contains all of the internal structures between the chest and the pelvis.

  • antihistamine: Drug that blocks cell receptors for histamine, either to prevent allergic effects like sneezing and itching or to reduce the rate of certain secretions in the stomach.

  • bladder: The bladder is a thick muscular balloon-shaped pouch in which urine is stored before being discharged through the urethra.

  • CT scan: Also known as computerized tomography, computerized axial tomography or CT scan. A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images of the body. Shows detailed images of any part of the body, including bones, muscles, fat and organs. CT scans are more detailed than general X-rays.

  • cyst: An abnormal sac containing gas, fluid or a semisolid material. Cysts may form in kidneys or other parts of the body.

  • cysts: Abnormal sacs containing gas, fluid or a semisolid material.

  • diabetes: A medical disorder of increased blood sugar levels that can cause bladder and kidney problems.

  • fetus: An unborn offspring from the end of the eighth week of conception until birth.

  • flushing: Fitting two things so they are completely level and form an even surface.

  • gene: The basic unit capable of transmitting characteristics from one generation to the next.

  • hematuria: Blood in the urine, which can be a sign of a kidney stone or other urinary problem. Gross hematuria is blood that is visible to the naked eye. Microscopic hematuria cannot be seen but is detected on a urine test.

  • histamine: A hormone transmitter involved in local immune response regulating stomach acid production and in allergic reactions.

  • inflammatory: Characterized or caused by swelling, redness, heat and/or pain produced in an area of the body as a result of irritation, injury or infection.

  • intravenous: Also referred to as IV. Existing or occurring inside a vein.

  • intravenous pyelogram: Also referred to as IVP, intravenous urography or excretory urogram. An X-ray of the urinary tract. A dye is injected to make urine visible on the X-ray and show any blockage in the urinary tract.

  • ions: Electrically charged atoms.

  • IV: Also referred to as intravenous. Existing or occurring inside a vein.

  • IVP: Also referred to as intravenous pyelogram, intravenous urography or excretory urogram. An X-ray of the urinary tract. A dye is injected to make urine visible on the X-ray and show any blockage in the urinary tract.

  • kidney: One of two bean-shaped organs that filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters.

  • kidneys: One of two bean-shaped organs that filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters.

  • non-ionic: Not relating to ions.

  • pelvis: The bowl-shaped bone that supports the spine and holds up the digestive, urinary and reproductive organs. The legs connect to the body at the pelvis.

  • radiation: Also referred to as radiotherapy. X-rays or radioactive substances used in treatment of cancer.

  • radiographic: X-ray.

  • radiologist: Doctor specializing in the interpretation of X-rays and other scanning techniques for the diagnosis of disorders.

  • steroid: An organic fat-soluble compound.

  • stone: Small hard mass of mineral material formed in an organ.

  • tumor: An abnormal mass of tissue or growth of cells.

  • ureter: One of two tubes that carry urine from the kidneys to the bladder.

  • ureters: Pair of tubes that carry urine from each kidney to the bladder.

  • ureters: Tubes that carry urine from the kidneys to the bladder.

  • urinary: Relating to urine.

  • urinary tract: The system that takes wastes from the blood and carries them out of the body in the form of urine. Passageway from the kidneys to the ureters, bladder and urethra.

  • urinate: To release urine from the bladder to the outside. Also referred to as void.

  • urine: Liquid waste product filtered from the blood by the kidneys, stored in the bladder and expelled from the body through the urethra by the act of urinating (voiding). About 96 percent of which is water and the rest waste products.

  • urologist: A doctor who specializes in diseases of the male and female urinary systems and the male reproductive system. Click here to learn more about urologists. (Download the free Acrobat reader.)

  • vas: Also referred to as vas deferens. The cordlike structure that carries sperm from the testicle to the urethra.

  • vein: Blood vessel that drains blood away from an organ or tissue.

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