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The most common of all urologic studies and is also commonly referred to as excretory urogram. It is a test that uses contrast agent (dye) that is injected into a vein to outline the kidneys, ureters and bladder on an X-ray. A urologist is likely to order this test if a patient complains of pain in their side, blood in the urine (hematuria) or any stone-related symptoms. It may also be utilized as a screening test to prompt your urologist to obtain another imaging test for further information.
This test is performed in a hospital radiology department or in a health care provider's office by an X-ray technician 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 of the abdomen and pelvis is a basic part of this examination and this is usually done without dye. This helps to determine the proper radiographic technique and patient positioning. A single film of the abdomen that includes the pubic bone may suffice in some patients, whereas in others, an additional film is focused on the kidneys. A full set of specific kidney films may be of value in a patient suspected of having small kidney stones. The dye will travel through the bloodstream to the kidneys and the kidneys will filter the dye out of the blood and send it down through the ureters into the bladder. While this is occurring, X-rays are taken at specific time intervals, from two to 10 minutes. These X-rays will show any tumors, cysts, stones or other structural and functional abnormalities. At the end, the patient will be asked to urinate for final images to see how well the bladder has emptied. The entire test can take up to one hour. The patient can immediately resume their daily activities. The primary risk of IVP is a reaction to the dye. The overall incidence rate for reactions ranges from three to 13 percent. 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. Statistics estimate major reactions in one in 200 to one in 2,000 patients. Patients with certain health factors — a history of hay fever, asthma or hives — are at greater risk as are those with congestive heart failure, diabetes and a prior reaction. Administering antihistamines or steroids prior to the exam may prevent any reactions. Also, nonionic contrast agents are dyes that have been recently developed which have lowered the incidence of adverse reactions. 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 radiation.
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