Radiology procedure (i. V. P.)

        RADIOLOGY PROCEDURE (I. V. P.)

Here’s a complete guide to the X-ray Intravenous Pyelography (IVP) procedure, commonly used in radiology to evaluate the urinary system as ( kidney, uretor, and bladder)

✅ Definition:

Intravenous Pyelography (IVP) is a radiographic examination of the kidneys, ureters, and urinary bladder using iodinated contrast material injected intravenously to visualize the urinary tract on X-ray.

📌 Indications:

  • Suspected urinary tract obstruction (e.g., stones)
  • Hydronephrosis
  • Recurrent urinary tract infections
  • Congenital abnormalities of the urinary tract
  • Renal trauma
  • Tumors or masses in the urinary system
  • Assessment before urological surgery

🚫 Contraindications:

  • Iodine or contrast allergy.
  • Renal insufficiency or high serum creatinine
  • Pregnancy
  • Multiple myeloma
  • Severe dehydration
  • Pheochromocytoma (may cause hypertensive crisis with contrast)

🧼 Patient Preparation:

  1. Explain procedure to the patient and obtain informed consent.
  2. Fasting: 6–8 hours prior to procedure.
  3. Bowel preparation: Mild laxative or enema night before to clear bowel gas and feces.
  4. Check renal function tests (serum urea/creatinine).
  5. Check allergy history to contrast media.
  6. Ask female patients about pregnancy.
  7. Advise patient to void just before the procedure starts.

💉 Contrast Used:

  • Water-soluble iodinated contrast media, e.g.:
    • Iohexol (Omnipaque)
    • Iopamidol (Isovue)
    • Iodixanol (Visipaque)
  • Dose: ~1 ml/kg body weight, injected IV (commonly 30–50 ml in adults)

📷 Procedure / Method:

  1. Take a preliminary KUB X-ray (scout film) to identify calcifications or gas patterns.
  2. Inject IV contrast rapidly.
  3. Take serial X-ray films at timed intervals to capture:
    • Nephrogram phase (1–2 min)
    • Pyelogram phase (5–15 min)
    • Ureter and bladder filling (15–30 min)
  4. Ask patient to void, then take a post-void film to assess bladder emptying.

🎞️ Filming:

  • Scout film (pre-contrast)
  • 1 min film (nephrogram phase)
  • 5 min film (contrast in calyces and pelvis)
  • 10–15 min films (ureter and bladder visualization)
  • Post-void film
  • Optional oblique or compression views for better delineation

❤️ After-Care:

  • Observe for allergic reactions to contrast (rash, dyspnea).
  • Encourage hydration to flush contrast.
  • Monitor urine output.
  • Educate patient to report pain, fever, hematuria post-exam.

🦠 Diseases Detected:

  • Renal calculi (stones), V. U. J, P. U. J. 
  • Hydronephrosis
  • Ureteral obstruction
  • Bladder tumors/ diverticula
  • Congenital anomalies (e.g., horseshoe kidney, duplication)
  • Vesicoureteral reflux
  • Ectopic kidney 
  • Pyelonephritis
  • Polycystic kidney disease.
  •                        *************

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