Urography/Pyelography Flashcards
the general term for the radiographic examination of the urinary system with the use of a radiopaque contrast media
Pyelography/Urography
What are the methods of doing urography?
- Excretory (Antegrade)
- Retrograde
- in this examination of the urinary system the contrast media is injected into the veins and the contrast medium will move downward
- true functional study
- traveling in the normal excretory direction of flow
Excretory (Antegrade)
IV Contrast Media may be administered by either?
- Bolus Injection
- Drip Infusion
- one in which the entire dose of contrast media is injected into the venous system at one time
- used typically for maximum contrast enhancement
Bolus Injection
- introduction of contrast media with the use of catheter or against the flow of blood or gravity.
- in this examination the contrast media is injected
into the lower canal with the use of catheter and
the contrast medium will move upward - non-functional examination of the urinary system
Retrograde
- method whereby contrast media is introduced into the venous system via connective tubing attached to the I.V. site
Drip Infusion
What are the types of Excretory Urography?
- Routine pyelography
- Timed, Minute, Rapid, Hyertensive Pyelography/Urography
- Drip-Infusion Pyelography
- Excretory Urethrography
- general or common method of examining the urinary tract for non-specific condition of the patient
Routine Pyelography
- special method of examining the urinary tract for cases of patient’s with high blood pressure.
Timed, Minute, Rapid, Hypertensive Pyelography/Urography
– special radiographic examination of the urinary tract which is done when the ordinary or routine IVP fails to evaluate kidney functions.
Drip-Infusion Pyelography
– radiographic examination of the male urethra which is done during the time of micturation or urination.
Excretory Urethrography
- x-ray films of the bladder and urethra taken after the bladder is filled with a contrast material and while the patient is expelling urine. .
Voiding Cystourethrography
What are the types of retrograde urography?
- Retrograde Pyelography
- Retrograde Ureterography
- Retrograde Cystography
- Retrograde Urethtograpy (RUG)
– radiographic examination of the renal pelvis and calyces, the ureters and bladder with the use of long
catheter and injection of dye in reverse pattern.
Retrograde Pyelography
– radiographic examination of the ureters in the reverse pattern.
Retrograde Ureterography
– radiographic examination of the urinary bladder with the use of a retention catheter.
Retrograde Cystography
– radiographic examination of the male urethra following the injection of a dye in the urethral meatus.
Retrograde Urethrography (RUG)
- radiographic procedure in which contrast media is injected intravenously
Excretory Urography or Intravenous Pyelography or Intravenous Urography
What are the purpose of the study?
1 To visualize the collecting portion of the urinary system.
2. To assess the functional ability of the kidneys.
3. To evaluate the urinary system for pathology or anatomic anomalies
What are the contrast media used?
Iodine-based solution such as Hypaque, Telebrix, Conray, Renografin and oth
2 TYPES OF IODINATED CONTRAST MEDIA AVAILABLE
FOR INTRAVENOUS USE
- Ionic - media whose molecules dissociate into 2 charged particles when place in solution, resulting in higher osmolality
- Non Ionic:
- Produce fewer adverse reactions
- more expensive
- Media whose molecules remain whole in solution
- Flushing of the skin/ temporary hot flash
- Metallic taste in the mouth
- Nausea
- Vomiting
- Few hives or urticaria
Mild Reaction
- Exceeding number of hives or giant hives
- Tachycardia
Moderate Reactions
- Dyspnea
- Sudden hypotension
- Loss of consciousness
- Cardiac arrest
Severe Reactions
abnormal condition of no urine production
Anuria
Indication of the study:
- Ruling out of stones
- Presence of Inflammation
- Internal Defects
- Hydronephrosis
- Hematuria
malignant tumor of cells (called plasma cells) in the bone marrow
Multiple myeloma
a disorder of the pancreas that causes
an increase in blood glucose levels
Diabetes millitus
tumor of the adrenal glands
Pheochromocytoma
condition in which the kidneys stop functioning and do not produce urine
Renal Failure
Patient Preparation:
- Light evening meal.
- Give either 4 dulcolax tablet or castor oil to facilitate evacuation.
- NPO after midnight.
- No breakfast and give dulcolax suppository.
- Report for the examination early in the morning.
The patient should void just before the examination is performed for the following reasons:
- A bladder that is too full could rupture, especially if compression is applied early in the exam
2.Urine already present in the bladder dilutes the contrast media that accumulates there
Materials needed for the examination:
- 30cc of contrast media
- 18-22 gauge needle (Adult) 23-25 gauge needle (pediatric)
- 1 ampoule or vial benadryl
- 2.5 ml syringe
- 250-500 ml D5W
- 30 cc syringe
- 1 Venoset
- Cold towel
- Emesis basin
What are the projections in Urography?
- Scout AP Projection
- Nephrogram/Nephrotomogram
- 5 minute image AP Projection
- 10-15 minute image AP Projection
- 20 minutes Oblique RPO and LPO Position
- Postvoid AP erect
- Alternative PA prone
Aftercare:
- Observation for 6 hours.
- Watch for late contrast reactions.
- Prevention of dehydration.
- In high risk patients-renal function tests should be done to watch for deterioration.
