Retrograde pyelogram
Encyclopedia
Retrograde Pyelogram is a urologic procedure where the physician injects contrast into the ureter
in order to visualize the ureter and kidney. The flow of contrast (up from the bladder to the kidney) is opposite the usual flow of urine, hence the retrograde name.
Reasons for performing a retrograde pyelogram include identification of filling defects (e.g. stones or tumors), as an adjunct during the placement of ureteral stents or ureteroscopy
, or to delineate renal anatomy in preparation for surgery. Retrograde pyelography is generally done when an intravenous excretory study (IVP or contrast CT scan) cannot be done because of renal disease or allergy to intravenous contrast.
Relative contraindications include the presence of infected urine, pregnancy and contrast allergy.
The procedure requires cystoscopy
and the placement of a small tube into the lower part of the ureter to inject contrast and opacify the ureter and renal pelvis. Fluoroscopy
, or dynamic X-Rays, is typically used for visualization. The procedure is usually done under general or regional anesthesia
.
Ureter
In human anatomy, the ureters are muscular tubes that propel urine from the kidneys to the urinary bladder. In the adult, the ureters are usually long and ~3-4 mm in diameter....
in order to visualize the ureter and kidney. The flow of contrast (up from the bladder to the kidney) is opposite the usual flow of urine, hence the retrograde name.
Reasons for performing a retrograde pyelogram include identification of filling defects (e.g. stones or tumors), as an adjunct during the placement of ureteral stents or ureteroscopy
Ureteroscopy
Ureteroscopy is an examination of the upper urinary tract, usually performed with an endoscope that is passed through the urethra, bladder, and then directly into the ureter...
, or to delineate renal anatomy in preparation for surgery. Retrograde pyelography is generally done when an intravenous excretory study (IVP or contrast CT scan) cannot be done because of renal disease or allergy to intravenous contrast.
Relative contraindications include the presence of infected urine, pregnancy and contrast allergy.
The procedure requires cystoscopy
Cystoscopy
Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope.Diagnostic cystoscopy is usually carried out with local anaesthesia...
and the placement of a small tube into the lower part of the ureter to inject contrast and opacify the ureter and renal pelvis. Fluoroscopy
Fluoroscopy
Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope. In its simplest form, a fluoroscope consists of an X-ray source and fluorescent screen between which a patient is placed...
, or dynamic X-Rays, is typically used for visualization. The procedure is usually done under general or regional anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...
.