Intravenous urogram

Published by Bupa’s Health Information Team, June 2011.

This factsheet is for people who are having an intravenous urogram, or who would like information about it.

An intravenous urogram (also known as an intravenous pyelogram) is a type of X-ray used to examine the urinary system. The urinary system includes the kidneys, the bladder, the urethra and the ureters (the tubes that join the kidneys and bladder together).

You will meet the radiographer or doctor carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About intravenous urogram

An intravenous urogram is a test that allows your doctor to look at your urinary system, using a special dye (contrast medium) that shows up on X-ray.

The dye is injected into one of your veins and travels through your bloodstream, kidneys, ureters and bladder before being passed out in your urine. The dye helps to show your urinary system more clearly than an ordinary X-ray. Your doctor will be able to see how quickly and efficiently your urinary system is working and how well it’s dealing with fluid and waste. 

Intravenous urogram used to be the standard test for looking at many different urinary problems, including:

• kidney and bladder stones
• tumours
• cysts
• an enlarged prostate gland
• narrowing of your ureters

However, a newer type of test called a CT urogram is now frequently carried out for these conditions instead. Which test you have will depend on your individual circumstances and what is available at the hospital where you’re having the test.

What are the alternatives to intravenous urogram?

Depending on what you’re being tested for, your doctor may suggest an alternative imaging test. This may include:

• a CT urogram – this involves taking a CT scan of your urinary tract before and after injection of a dye to show up your urinary system
• an X-ray of your abdomen (tummy)
• an ultrasound – this uses sound waves to produce an image of your urinary system
• a standard CT scan – this uses X-rays to produce a three-dimensional image of your urinary system

Preparing for an intravenous urogram

Intravenous urogram is usually done as an out-patient procedure in a hospital radiology department. This means you won’t need to stay overnight. The test is usually carried out by a radiographer – a health professional trained to perform imaging procedures.

You may be asked not to drink for a few hours before having a urogram. You may also be asked to take a laxative before the test, to make sure your bowel is clear of faeces. The hospital will give you detailed advice before the test.

If you have diabetes, tell the radiology department when you receive your appointment. You will be given instructions about what to do before and after the test. You should also tell your doctor if you’re pregnant. Intravenous urogram may not be suitable if you’re pregnant and your doctor may suggest an alternative.

Before your test, your radiographer will ask you whether you have any allergies or asthma.
The radiographer will also discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during an intravenous urogram

The procedure usually takes about an hour. You will be asked to empty your bladder before the test.

In the X-ray room you will be asked to lie on your back on the X-ray table. The radiographer will take the first X-ray pictures of your abdomen without the dye.

The radiographer will inject the dye into a vein in your hand or arm, and take more X-rays of your abdomen. You may be asked to move position and lie on your stomach while the X-rays are taken.

To help improve the images of your kidneys, a tight band may be placed across your abdomen. You may also be asked to empty your bladder before another X-ray is taken.

What to expect afterwards

You will usually be able to go home when you feel ready. You will be able to drive if you wish.

You shouldn't have any problems passing urine or see any change in the colour of your urine after the test. If this does happen, ask your GP for advice.

Before you go home, the radiographer may tell you when you can expect to get your results.

What are the risks?

As with every procedure, there are some risks associated with an intravenous urogram. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

You will be exposed to some X-ray radiation during the test. The amount of radiation is always kept to a minimum during any test. The level of radiation you receive during a urogram is about the same as the background radiation that you would get naturally from the environment over about 14 months.

If you’re pregnant, or think you may be, tell your doctor before your appointment. Your doctor may suggest an alternative test.

Side-effects

These are the unwanted but mostly temporary effects you may get after having the procedure.

You may get a flushed, warm feeling as the dye flows round your body. You may also have some mild itching or a metallic taste in your mouth after the dye is injected. This usually passes quickly. 

Complications

Complications are when problems occur during or after the procedure.

It's possible to have an allergic reaction to the dye, though this is rare. If you have any itching or start to feel short of breath after the dye has been injected, tell your radiographer immediately. Medicines are available to treat an allergic reaction.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.