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Retrograde Pyelography

Like an IVP, retrograde pyelography uses special contrast agent (dye) to produce detailed X-ray pictures of the ureters and kidneys. The difference is that in retrograde pyelography the dye is injected directly into the ureters rather than into a vein. While newer diagnostic technologies have replaced this test for many functions, retrograde pyelography may still yield better definition of the upper urinary tract, particularly the ureter and kidney. Commonly performed when an IVP produces an inadequate image, it also complements cystoscopy while investigating a patient with hematuria or recurrent or suspected cancer.

This test is performed in a hospital radiology department or in a health care provider's office by a urologist and is typically carried out under general anesthesia. Cystoscopy is performed and the small catheter is inserted into the opening of the ureter in the bladder. Dye is injected and fluoroscopy is performed to visualize the ureters and kidneys. The entire study can take 15 to 30 minutes and is done on an outpatient basis.

While pyelography is considered generally safe, the major risk involves a reaction to the iodine-based dye. Minor reactions include hot flashes, nausea and vomiting. These are usually treated successfully with 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. There may be additional problems such as a urinary tract infection or pain afterward (see cystoscopy).

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



Reviewed January 2011

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Retrograde Pyelography Glossary
  • anesthesia: Loss of sensation in any part of the body induced by a numbing or paralyzing agent. Often used during surgery to put a person to sleep.

  • 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.

  • cancer: An abnormal growth that can invade nearby structures and spread to other parts of the body and may be a threat to life.

  • catheter: A thin tube that is inserted through the urethra into the bladder to allow urine to drain or for performance of a procedure or test, such as insertion of a substance during a bladder X-ray.

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

  • cystoscopy: Also known as cystourethroscopy. An examination with a narrow, flexible tube-like instrument passed through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.

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

  • fluoroscopy: Imaging technique that takes a real time "movie" of the body.

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

  • general anesthesia: Person is put to sleep with muscle relaxation and no pain sensation over the entire body.

  • 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.

  • infection: A condition resulting from the presence of bacteria or other microorganisms.

  • 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.

  • 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.

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

  • retrograde: Backwards.

  • retrograde pyelography: Radiographic imaging of the ureters and collecting system of the kidneys by introducing a dye opaque to X-rays by way of urinary catheter.

  • 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.

  • urinary tract infection: Also referred to as UTI. An illness caused by harmful bacteria, viruses or yeast growing in the urinary tract.

  • 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.)

  • urology: Branch of medicine concerned with the urinary tract in males and females and with the genital tract and reproductive system of males.

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

Retrograde Pyelography Anatomical Drawings

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