IVP

Your Intravenous Pyelogram (IVP)

What is the test used for?
Intravenous pyelography (IVP) is used to examine the "urinary tract", that is the kidneys, ureters and bladder. Using an IVP we can look at the size and outline of the kidneys, get an idea of how well they function, see the inside structure (kidney "pelvis" and "calyces"), make sure both ureters are doing their job of transferring urine from the kidneys to the bladder, and look at the outline of the urinary bladder.

What is the preparation for the test?
The kidneys are likely to be obscured by normal gas and faeces within the bowel. We can obtain much clearer, and hence more accurate pictures, of the kidneys if the bowel is as empty as possible. There is a "bowel preparation" which you will be asked to start 2 days before the test. Follow the instructions with the kit (see sheet). Unfortunately, watery diarrhoea is the desired effect of the preparation.

When you present for your appointment, you will also be given an allergy form to fill out. This is to give us a history of any allergies, and also what medications you are taking.

Will I have to undress?
You will be asked to remove most of your clothes, but may keep wearing your underpants. You will be asked to change into a cotton gown. This is because buttons, clips, zippers etc. show up too well on x-ray and can be confusing to interpret or may hide abnormalities.

Where will I be for the test?
You will be asked to lie on the IVP table, which has a padded top. We can also use pillows and foam pads to make things more comfortable for you. You may also have a blanket, for warmth. The examination is performed with you lying on your back. Some images may also be taken with you lying on your stomach (prone), rolled half way to either side.

How is the test done?
Two plain x-ray images will be obtained to localise your kidneys. One of these is a "tomogram", which is where the x-ray tube moves over you, while the x-ray film moves in the opposite direction underneath you. Using this technique, the level of the kidneys in your body is revealed as the other structures in the abdomen are blurred out of the image.

You will be given an injection of x-ray contrast. This liquid has been designed to be efficiently taken out of your blood by the kidneys. The contrast contains Iodine which shows up on x-rays. It is important to tell the staff if you have any allergy to x-ray contrast.

The contrast is given via a small needle in the arm or hand. The needle is about the size of that used when blood tests are taken. The injection may make you feel warm for a few minutes, and also give you a metallic taste in the mouth. These feelings dont' last very long and are quite normal, although many people experience nothing at all. You will be asked to hold your breath during each x-ray, but only for 10 or 15 seconds. We will also use a compression device around your waist. The reason for this is to compress the ureters and keep the contrast in the kidneys allowing us to obtain good images of your kidneys. This compression is applied for about 10 minutes. It is then released and the contrast fills the ureters, allowing us to obtain good pictures of them.

A standard IVP will require a minimum of 8 films, although several more may be required depending on what your doctor is looking for and/or the function of your kidneys. Each examination is customised to the individual patient.

How long will it all take?
About 30 - 40 minutes. We allow a longer booking time, as there may be
an obstruction to a ureter, and the examination may take longer.

And after the test?
You can go to the toilet, get dressed and go home.
Resume your normal diet.

Radiation?
Ionising radiation is used. (See radiation page)