How to prepare for urography with contrast. Indications and contraindications for survey urography

In medicine, there are many different ways to diagnose pathologies of the kidneys, bladder and ureters. The most widely used is kidney urography, we will learn what it is from our article.

Thanks to this method, it is possible to determine the condition of the urinary organs excretory system and identify pathological abnormalities. At the same time, we note that in last years The urography method has often begun to replace CT and MRI, especially since these procedures are painless and their price is an order of magnitude lower.

Urography is a safe and highly informative x-ray diagnostic method. internal organs genitourinary system. The appointment of a procedure is required if there is a suspicion of urinary tract infection, as well as ureters, characterized by problems with the removal of urine from the body. Thanks to urography, cysts and the renal structure are determined.

Diagnosis using urography must be carried out by specialized specialists who have been trained in this medical aspect. The results of urography enable the urologist to make a final and accurate diagnosis, which makes it possible to develop appropriate and effective technique drug therapy.

The essence of the procedure is introduction into the kidney contrast agent, which is highlighted in the X-ray image and gives a clearer image of the structure of the organs of the urinary system.

Attention. Previously, urography was practically the only method that allowed an accurate diagnosis of the patient. But due to the fact that this is not a very pleasant event that causes discomfort to the patient, today doctors are increasingly resorting to alternative methods kidney diagnostics such as MRI and CT.

Diagnosis through urography is carried out at any age (with the exception of children under 1 month of age), serious complications does not carry, except that it causes discomfort. But we’ll talk in more detail about the advantages and disadvantages of this technique further.

Benefits of urography

There are a number positive features that the X-ray procedure has:

1. Provides an opportunity to obtain informative information about the condition of the tissues, functionality and excretory function of the organs of the urinary system. Thanks to the procedure, the doctor can make an accurate diagnosis of the patient and develop effective treatment diseases.
2. The X-ray image clearly shows the parenchymal structures, the presence of stones and the condition of the pyelocaliceal segment.
3. The stage is determined pathological process And functional feature kidney
4. Doesn't deliver much pain, just some discomfort.
5. Does not cause injury to the tissues of internal organs
6. Allows you to identify congenital developmental anomalies.
7. Possible side effects after the procedure disappear quickly enough and there are no serious complications.
8. The location and degree of the inflammatory process is clearly determined.
9. Urography can be prescribed even in childhood.
10. Several types of urography allow the doctor to select the optimal research option for making an accurate diagnosis.
11. Simple preparation for the procedure does not require taking expensive medications.
12. During urography, a person receives a minimal dose of radiation.
13. It is considered a highly informative and reliable method for diagnosing kidneys.

What information can be obtained from the procedure?

Thanks to urography of internal organs, you can obtain the following data:

• outline of internal organs;
• localization of the lesion;
• size;
• shape;
• functional features.

In addition to all the advantages, it is also necessary to highlight the fact that during the procedure it is also possible to diagnose the condition of other nearby internal organs. Thus, concomitant pathological processes are excluded or confirmed.

Disadvantages of urography

Among the many advantages, urography also has its disadvantages.

These include:

1. Insufficient information about cellular structure organs, tissues and perinephric space.
2. Inability to determine the functional characteristics of urination.
3. The presence of allergic reactions to iodine.
4. It is impossible to carry out this diagnosis in the presence of pathologies such as renal, liver and heart failure.
5. Radiation exposure of the body, albeit in small doses.

Indications for urography

This type of diagnosis is prescribed by a doctor to confirm or exclude suspicions of a particular diagnosis.

The procedure is prescribed in situations where the patient presents with the following complaints:

• presence of blood in the urine;
• lower back pain accompanied by high fever;
• renal colic.

Urography is also indicated before surgical intervention in order to evaluate the results of future surgery and analyze the dynamics of previous conservative treatment.

Contraindications and side effects

In some situations instrumental method diagnostics can provide Negative influence and lead to complex consequences. First of all, the following patients are excluded: pregnant women and nursing mothers.

In case of pregnancy, X-ray exposure is strictly contraindicated, and in cases of nursing mothers, if there are significant indications, breastfeeding should be avoided for several days.

Contraindications to urography will be as follows:

• renal, liver, heart failure;
• previous heart attack and stroke;
• hyperthyroidism;
• decompensated diabetes mellitus;
• low degree of blood clotting;
• glomerulonephritis;
• allergic reactions to contrast agent;
• absence of one kidney (does not apply to survey urography);
• radiation sickness caused by radiation exposure.

Attention. Before prescribing an irradiation procedure, the doctor is obliged to calculate the patient’s radiation doses, focusing on the established annual standards.

It is worth noting that patients prone to allergic reactions are at risk of the following complications:

• hives;
• Quincke's edema;
• anaphylactic shock;
• laryngospasm.

Many patients experience the following adverse reactions after administration of a contrast agent:

• nausea;
• vomit;
• dizziness;
• body heat;
• a feeling of iron taste in the mouth.

Before undergoing renal urography, patients should be informed about possible consequences and adverse reactions.

Types of kidney urography

Urography can be performed different ways, the choice remains only with the attending physician, who is based on the patient’s complaints and the individual characteristics of his body.

Survey urography

One of the simplest x-ray examinations of the kidneys, which makes it possible to obtain a picture abdominal cavity and does not require the administration of a contrast solution. The results of the study in this case are limited by the general condition of the internal organs, the presence of injuries, neoplasms, cysts, stones and significant deformations.

The main advantage of survey urography is the speed of obtaining results and accessibility for patients. Modern equipment allows you to display a picture of the abdominal cavity on the monitor and quickly obtain diagnostic results.

Often, a survey urography is prescribed before a more extensive urography procedure using a contrast agent.

Excretory urography

The method consists of intravenous administration of a contrast solution, which makes it possible to determine not only anatomical features internal organs, but also physiological. Urografin, Cardiotrast, Vizipak, and their analogues are used as a contrast agent. After administration, the solution reaches the kidneys in just a few minutes, going through the entire filtration path.

The solution is an important special diagnostic sign; if any mechanical or pathological obstacles arise along the way, this can be seen in the images with high accuracy. To obtain a reliable diagnostic result, a number of photographs are taken in different projections.

Features of the procedure:

1. X-rays are taken even at the time of administration of the contrast solution.
2. Allows you to evaluate the excretory functions of the kidneys and determine the rate of filling of the renal pelvis and urea.
3. During the study period, the stones, their size, shape and structure are clearly determined.
4. Allows you to identify tumor growths and cysts.
5. Shows the structure of all organs of the urinary system.

Intravenous urography

The method involves the constant administration of a contrast solution over a long period of time. A drip system is used for this. This procedure takes a fairly long period, so for this period the patient is left in a hospital setting.

As a rule, it is prescribed before complex operation. Diagnostics allows you to evaluate the speed of urine passage through the ureteral canals and the time it takes to fill the ureter. The results obtained are compared with hemodynamic parameters.

Rules for preparing for the procedure

Before urography, the patient is given appropriate recommendations, which he must heed in order to obtain a reliable picture of the disease. Preparation for urography of any type has identical characteristic rules.

The rules for preparing for the procedure are as follows:

1. 3 days before the procedure, the patient must refuse products that cause increased gas formation. For example, legumes, carbonated drinks, fresh cabbage, baked goods, raw vegetables.
2. If you have a tendency to increased flatulence It is recommended to take it within 7 days before the procedure Activated carbon. The recommended dose is 1 tablet per 10 kg of patient weight, taken once a day.
3. Test for presence allergic reaction to the solution. If previously noted similar phenomena, you should definitely tell your doctor about this.
4. The last meal before urography should take place no later than 8 hours. You should also limit your fluid intake.
5. As directed by your doctor, you should empty your bladder, remove all metal products from yourself.
6. If the patient experiences an increased feeling of fear or apprehension, it is allowed to take a sedative shortly before the procedure.

Advice. To reduce gas formation in the intestines, experts recommend drinking 30 grams before urography. castor oil, this equals 3 teaspoons.

In addition, the day before the procedure, you should adhere to proper nutrition, it is necessary to exclude spicy, salty, fried and smoked foods.

Rules for urography

Urography of the kidneys does not take much time and is quite easy.

The rules are as follows:

1. The duration of urography depends on the severity of the disease, the presence of stones and individual characteristics body.
2. Survey urography carried out in a standing position. To prevent irradiation of other parts of the body (chest, genitals), they are covered with protective aprons. The irradiation zone includes the area of ​​the 3rd and 4th vertebrae.
3. Intravenous urography using a contrast agent is performed on the patient in the supine position. The drug is administered intravenously, after which images are immediately taken. The beginning of urography is always accompanied by minor discomfort, but after some time these sensations disappear.
4. After administration of the solution, the contrast agent fills the ureters and kidney tissue. Pictures are taken at a certain interval, the first pictures are taken with the patient standing, and the subsequent ones with the patient lying on the couch.
5. If indicated, the images are repeated some time after the administration of the contrast solution.
6. The duration of urography ranges from 30 minutes to 1 hour.
7. After the procedure, the patient can lead his usual lifestyle; he can already eat and drink liquids.
8. At the time the image is taken, the patient must hold his breath. If this is not done, the image will show doubling of the stones and the pyelocaliceal segment.

The interpretation of the tests is carried out by the attending physician.

Important. The urography procedure requires emptying not only the bladder, but also the intestines. Therefore, it is recommended to drink a laxative a few hours before starting if you cannot have a bowel movement. naturally. Otherwise, an enema will be prescribed.

Possible side effects after urography they do not require treatment; they go away on their own after some time. For faster removal of the contrast agent from the body, it is recommended to drink milk, green tea and natural freshly squeezed fruit juices.

The video in this article will tell readers about the effectiveness of a procedure such as kidney urography.

Every day doctors are increasingly diagnosing various diseases kidney

To make a final diagnosis, patients undergo a number of laboratory and instrumental studies.

Doctors prescribe ultrasonography, magnetic resonance imaging and urography. These methods allow specialists not only to determine external kidney damage, but also their internal changes.

Urography (cystography) is an x-ray examination that studies structural changes kidneys and determining urolithiasis pathologies. Urography is performed by specialized specialists. Thanks to the results of urography, the doctor will be able to definitively make a diagnosis and prescribe appropriate treatment.

During diagnosis, doctors inject a contrast agent into the kidney and it is highlighted on the x-ray. Thus, when a substance enters the urinary canals, it is easy to notice, which allows a complete study of the structure of the genitourinary system.

Previously, this technique was used quite often, but since the procedure is not pleasant, urography is now being replaced with alternative diagnostics.

What does a survey type of urography show?

Survey urography of the kidneys is performed to determine:

• size and weight;
• border contours;
• position and mobility;
• forms;
• general condition of the abdominal organs.

Thanks to this information, the doctor can accurately diagnose and prescribe the correct treatment.

The main advantage this study The fact that all abdominal organs can be seen is considered. Thus, the doctor determines or excludes other pathological processes.

In what cases is urography prescribed?

Urography was developed so that the functionality of the kidneys could be assessed. Therefore, in almost all cases when there is a suspicion of a pathological process, doctors prescribe this diagnostic method.

With the help of survey urography, doctors can determine:

• presence of benign or malignant neoplasm or tumor lesion;
• structural changes in kidney tissue;
• stones and small concretions in the kidneys;
• abnormal structure of the kidneys and urinary system;
• possible complications of kidney injury;
• nephrogenic hypertension (persistent arterial pressure caused by disease of the renal parenchyma), pyelonephritis ( inflammatory disease renal pelvis), glomerulonephritis (damage to the renal glomeruli), hydronephrosis (enlargement of the renal pelvis caused by impaired outflow of urine) and tuberculosis;
• reasons for the appearance of blood in urine.

Doctors may prescribe a survey urography if they suspect the development of genitourinary infectious processes caused by renal colic. It is also possible to obtain an accurate picture of kidney function after surgery.

Urography can 100% determine the type and severity of the lesion, the stage of the pathological process. This allows doctors to select effective treatment.

In what cases is it prohibited to conduct survey urography?

Like other x-ray examinations, urography is not performed on women during pregnancy. Experts do not recommend performing such diagnostics on patients who have recently undergone contrast gastroscopy.

In such cases, the contrast agent makes visual examination of the kidneys difficult. If there are still indications for survey urography, then it is performed a few days after the previous study.

During this time, the intestines are cleared of barium residues. It is strictly forbidden to perform survey urography:

• women during pregnancy;
• patients with one kidney;
• patients with chronic radiation sickness.

Preparation for survey urography

Before starting a diagnostic study, the patient must donate blood from a vein. Thus, doctors confirm or rule out kidney failure. Also, the patient undergoes a test in advance to determine an allergic reaction to the injecting substance.

The main condition for survey urography is special diet, which includes several basic rules:

• It is forbidden to eat two days before the diagnostic test fresh vegetables and fruits that have not been pre-heat-treated;
• It is strictly forbidden to consume grains and beans, sweets and fresh baked goods within two days;
• per day it is necessary to reduce the amount of fluid consumed to a minimum.

By observing these simple rules You can achieve an increased concentration of urine, which in turn increases the contrast in the image.

You should not eat too much before the diagnosis. It is better to eat 10 hours before urography, and preferably if it is a light meal.

If diagnostic test If it is scheduled for the morning, it is advisable to do an enema before going to bed and in the morning. This way the gastrointestinal tract is cleansed intestinal tract. It's better not to have breakfast.

Preparation for urography depends on the type of diagnosis (survey, excretory or intravenous urography). Each urography has its own specific purpose, therefore, the preparation rules are different.

When performing a survey urography, it is very important that the intestines are not filled with gases. Therefore, it is necessary to eat for several days before the study dietary products. Also, doctors prescribe activated carbon or polyphelan.

You shouldn’t overeat before the procedure, but you shouldn’t be hungry either, because empty stomach Gases may form. Be sure to do two enemas - in the morning and before the study.

Using excretory urography, doctors determine the morphology of the kidneys. In this case, the presence of gases in the intestines may misinform the specialist.

The day before, doctors recommend drinking 30 grams of castor oil (about three teaspoons). This allows you to reduce gas formation in the intestines. Get rid of increased gas formation You can use activated carbon. To do this, you need to take six tablets in the morning and six in the evening.

Before intravenous urography, it is enough to adhere to proper nutrition for several days. Avoid fatty, spicy and sweet foods. This cleanses the gastrointestinal tract and makes the images clearer and more accurate.

How is kidney urography performed?

Observational urography does not take much time and is easy to perform. The patient assumes a supine position, and a pillow is placed under the head. This is the most comfortable position for the patient in which the main muscle groups are not strained. Before the diagnosis itself, the doctor talks with the patient, finding out the expressed discomfort and unpleasant feeling that the patient has been experiencing recently.

If the doctor does not ask, the patient must tell him about all the medications he has taken over the past month. The doctor directs the X-ray beam so that it is slightly lower than the xiphoid process.

The beam should pass strictly perpendicular to the body. at the moment when the device takes the picture, the patient must not breathe. If you breathe during this period, then in the picture you can see how the pyelocaliceal system or stones double.

Is survey urography harmful?

The human body may react negatively to the fact that a urographic examination was performed, namely:

• burning sensation in the veins into which the contrast agent was injected;
• nausea;
• hot flash;
• dizziness;
• iron taste in the mouth.

These conditions are considered normal and do not require special treatment. They will go away on their own in a few hours. To quickly remove the contrast agent from the body, doctors recommend drinking more, preferably fresh juices, green tea or milk.

If the patient has no contraindications to this research technique, then there are no adverse reactions accordingly. It is possible that short-term x-ray exposure will occur.

Also, doctors can perform survey urography on young children, since this type research - absolutely safe. Only the dosage of the contrast agent is determined by the child’s weight and the functionality of the liver and kidneys. Since it is very difficult to force a child to lie in one position for a long time, the diagnosis is carried out at an accelerated pace. To prevent an allergic reaction, children additionally take an antihistamine.

It is strictly forbidden to use this diagnostic method for children under one month. Before the procedure, parents should mentally prepare the baby so that it is not a surprise for him. Then diagnostics will pass quickly and painlessly.

How are plain urography analyzes interpreted?

The results of survey urography are deciphered by a specialist. Experts use two types of interpretation of results. When performing a survey urography, healthy kidneys look like clear clouds. Wherein left kidney slightly below the right.

The abdominal organs are turned towards the spine. The ureters and bladder were not detected on the image. If the patient has urolithiasis disease, then the stones are clearly identified. A “humpbacked” kidney is considered normal. In 42% of patients, one kidney is not visible.

Otherwise, the contrast agent should clearly visualize the kidneys. The bladder and ducts should be in a visible place. A healthy kidney has a homogeneous structure.

Doctors need to determine whether the contrast agent is leaving the kidneys. If it comes out, then this indicates a rupture of the ureters.

If the patient has diseased kidneys, the doctor will immediately determine this.

There are many ways to assess the condition of internal organs, including the genitourinary system: MRI, ultrasound, radiography, CT and others. Their disadvantage is that they often do not provide a complete picture. To fully diagnose anatomical and functional pathologies, a narrow range of methods is used, one of them is kidney urography using a contrast agent. What are the indications and contraindications for this procedure? How is it carried out and what consequences may arise after it?

A black and white image of organs located in the abdominal region and the space behind the peritoneum helps to determine their location. Their outline may be blurred, this is due to the fact that the projections of other organs are layered on top of each other. This method does not make it possible to assess the full functionality of the urinary organs. Contrast urography of the kidneys allows you to fully examine what cannot be seen with this (survey) method.

This procedure is carried out through the introduction of a contrast agent to the patient (against the background of the kidneys and other organs, the injected agent has greater contrast) and the production of x-rays. The essence of the method is based on the ability of this very substance to block X-ray radiation. It initially accumulates in the kidney and is then excreted by the excretory organs.

Types of procedure

The urinary system includes several organs. One part of them forms, and the other secretes urine. The system includes the kidneys (paired organ). Next, we will briefly consider the functions of the system, its pathologies, as well as the diagnostic method used to identify them.

Objectives of the structure

The main functions of the urinary system include:

• Maintaining water-salt balance.
• Product highlighting metabolic processes.
• Maintenance hormonal balance due to biologically active compounds synthesized in the adrenal glands.

Maintaining homeostasis and excretory function are considered vital tasks. The products of metabolic processes are excreted through the ureters. Urine accumulates in the bladder. The kidneys are bean-shaped parenchymal organs. They consist of medulla and cortical layers. The kidneys perform important task to detoxify the body.

System pathologies

Diseases may be congenital or genetic infectious nature. In the latter case, inflammation of specific components of the structure occurs. The pathological process predominantly affects the kidneys. Inflammation of other elements of the system, as a rule, poses less danger. However, in any case, pathological processes are accompanied by discomfort, pain, and pain. Genetic diseases are caused by anomalies in the structure of one or another organ. Due to these violations, it is difficult or impossible to possible education and urine output. Among genetic pathologies there are also anomalies in the formation of the body. These include, for example, the absence of one or two kidneys at once. In this case, death usually occurs immediately after birth. The ureter may also be missing or not enter the bladder. Developmental anomalies can also affect the urethra (excretory canal). Women are more at risk of contracting infections. This is due to the structural features of their urethra- they have it shorter than men. Due to this, the infectious agent quickly penetrates the system, rises to higher organs and provokes inflammation.

Diagnostics

To assess the condition of the urinary system, excretory intravenous urography is used. This method is an x-ray examination using a contrast agent. During routine imaging urinary tract are not viewed well enough. Survey intravenous urography allows you to get a more complete picture of the state of the system and its individual components. The contrast agent enters the bloodstream. From there it enters the kidneys and concentrates there. The contrast then exits through the urethra along with urine. Due to the presence of the substance, X-rays are blocked in accordance with the kidney structure. In the photographs it looks like white spots. The images obtained during diagnosis are called intravenous urograms or pyelograms.

Purpose of the study

Intravenous urography of the kidneys is prescribed in the following cases:

Intravenous urography: patient preparation

Before the procedure, you may need biochemical research blood. It is necessary to confirm the absence of renal failure. If it is present, the study is not carried out. This is due to the fact that the kidneys must normally secrete the contrast agent. The patient should also inform the doctor about the presence of an allergy to compounds containing iodine. Preparing for intravenous urography quite simple. It is not recommended to eat a few hours before the procedure. When the bowel is free, the X-ray image becomes clearer. Preparation for intravenous urography sometimes includes taking a laxative. This is needed for better cleansing intestines. A prerequisite in some clinics is that the patient signs consent to the procedure. Patients with diabetes mellitus and those taking metamorphine should stop taking it two days before the expected date of the study. Otherwise, the combination of this substance with contrast may cause tissue damage to the organs of the system.

Intravenous urography: how is the study done?

The patient should undress before the procedure. Intravenous urography is performed on the patient in the supine position. A radiopaque contrast agent is injected into the blood. The injection is carried out intravenously. In this case, the patient may feel a slight burning sensation. The substance penetrates the kidney tissue and ureter. During the procedure, the doctor takes several pictures, usually at intervals of 5-10 minutes. All this time the patient lies on the couch. Before taking the last image, the specialist may ask you to empty the bladder. In some cases, delayed (several hours later) images are taken. Typically, intravenous urography is performed within 30-60 minutes. You can go home immediately after completing the study. You are also allowed to eat after the procedure.

Possible side effects

When intravenous urography is performed, when contrast is administered, the patient may feel a metallic taste and warmth in the mouth. Usually such sensations pass quickly. IN in rare cases intravenous urography may cause an allergic reaction. Its severity may vary. In particular, allergies can manifest themselves in the form of swelling of the lips or small rash. Rarely, more serious reactions such as low blood pressure or difficulty breathing occur. To normalize the condition, the doctor’s office has all the necessary tools. Another quite rare negative manifestation considered insufficiency renal function.

Additional Information

Despite the diagnostic importance of the procedure, not everyone can undergo intravenous urography. Contraindications to the study include pregnancy, individual intolerance to contrast and compounds containing iodine. The procedure is also not recommended for people suffering from functional impairment.

Timely and reliable diagnosis is of great therapeutic importance, since it directly affects the success of treatment. In the process of identifying kidney diseases Renal urography is considered an effective diagnostic method.

Urography of the kidneys

Urography is an X-ray examination that allows one to evaluate the functionality of the renal structures and urinary system. The essence of the method is to administer a contrast agent to the patient, followed by X-ray examination. Diagnostics makes it possible to detect the presence of inflammatory foci, stones or tumor formations. The procedure is prescribed to patients of any gender and age, as it is one of the safest tests.

Indications for use

Urography shows how the patient’s kidneys work, so it has a fairly wide range of purposes.

The study is indicated to identify:

1. Benign and malignant tumor lesions;
2. Structural changes in renal tissues;
3. Stones and small concretions in the kidneys;
4. Abnormal structure of the urinary and kidney systems;
5. Possible consequences of kidney injuries;
6. Nephrogenic hypertension, pyelonephritis, glomerulonephritis and hydronephrosis, tuberculosis, etc.;
7. Reasons.

Urographic examination is prescribed for suspected genitourinary infectious processes, at renal colic, as well as to obtain a picture of the condition of the kidneys after surgical intervention. The method reliably determines the type and degree of damage, the stages of the pathological process, which allows the doctor to select the most effective therapeutic tactics.

Kinds

There are several types of urographic diagnostics:

• Infusion (intravenous with the use of a contrast agent);
• Observatory;
• Excretory.

Infusion (contrast) urography involves intravenous administration contrast agent using a dropper. Typically, in such a study, contrast is slowly introduced during the procedure, and images are taken on different stages diagnostics

Overview

Survey urographic diagnosis is standard x-ray examination and is performed without the use of contrast. As a result of the study, a rather meager picture of the disease is usually produced, although the doctor, based on the results of survey urography, is able to detect large stones and determine general structure kidney Usually similar procedure always prescribed before contrast urography.

Survey radiography is prescribed for lumbar injuries and renal colic, urolithiasis and hydronephrosis, tumors, etc. In fact, during the study, the specialist performs a survey image of the abdominal organs, which also shows the spine and bone structures, soft fabrics etc.

excretory

This method is also called intravenous or contrast urography, since the procedure is performed using a radiopaque agent. Typically, Cardiotrast, Urografin, Vizipak, Triombrast, etc. are used as contrast. The method is based on the use of renal filtration function, excretion of processed materials and release of metabolic substances.

The pyelocaliceal system is not visible during survey urography, therefore, to determine its condition and functionality contrast is introduced, the choice of which determines the quality of the results obtained. In order for the study to produce reliable and informative results, the contrast should not accumulate in tissues, be metabolized and participate in metabolic processes. In addition, the contrast agent must have minimal nephrotoxicity and maximum X-ray contrast.
On the video about excretory urography of the kidneys:

Infusion

The absolute indications for intravenous urographic examination are:

1. Urinary abnormalities;
2. Chronic inflammatory renal lesions;
3. Tumor processes in the kidneys;
4. Functional bladder changes;
5. Urolithiasis;
6. Prolapse of the kidneys, etc.

Also, contrast urography is often prescribed before surgery.

Preparation for the procedure

Preparation for survey and excretory urography of the kidneys is somewhat different:

• A survey study requires preliminary cleansing of the gastrointestinal tract. A few days before the test, you should avoid foods that contribute to flatulence, such as bread, legumes, milk and potatoes. It is necessary to cleanse the intestinal structures using sorbents (Polyphepan, activated carbon). On the eve of the review procedure and in the morning on the day of it, you will have to prepare by fasting; you are allowed to drink only unsweetened tea for breakfast. To avoid flatulence, it is not recommended to drink a lot of liquid.
• Preparation for intravenous renal urography with contrast also requires clearing the gastrointestinal tract to maximize renal visualization. The patient needs to exclude the same foods and follow the same rules as before survey urography. Before the study, the patient is given an enema, then the patient must empty the bladder.

If the patient is worried about nervousness, it is recommended to take sedative. If you are allergic to any medications or chemical substances, then you need to notify the doctor about this in advance. The patient is also required to sign consent for the diagnosis.

How is the procedure performed?

Survey urography of the kidneys for both adults and children is carried out in vertical position, X-rays are directed in a beam to the area of ​​3-4 vertebrae. During the exhibition chest and the genitals and limbs are covered with special protective equipment such as an apron. After 5 minutes the patient can be free.

If we talk about how intravenous renal urography is done, then the procedure begins with the patient positioning on a special table, after which a contrast agent is slowly injected into his vein. During the administration of a contrast agent to children or adults, the patient may experience some discomfort such as a burning sensation. X-ray contrast gradually penetrates the ureters and renal tissues. During excretory urography, several sequential images are taken at approximately 5-10 minute intervals.

During this entire time the patient is in horizontal position lying on the couch. Sometimes there is a need for delayed images, which are taken several hours after the contrast is administered. Typically, the duration of intravenous urography is approximately half an hour to an hour. After the procedure, the patient can go home and eat.

Administration of contrast during infusion renal urography

Contraindications

Overview and excretory urography is not performed on all patients without exception, since the study has a number of contraindications:

1. Severe form of liver or kidney damage;
2. Pregnancy, breastfeeding;
3. Pheochromocytoma;
4. Glomerulonephritis and other severe pathologies;
5. Thyroid pathologies such as thyrotoxicosis, etc.;
6. Allergy to iodine contrast agents;
7. Presence of bleeding or tendency to it;
8. Reduced blood clotting;
9. Kidney failure in acute or chronic form;
10. Treatment of diabetes with Glucophage.

In case of categorical contraindications to urography similar diagnostics are being replaced by safer studies, although less informative, e.g. ultrasound diagnostics, magnetic resonance or computed tomography.

What's the harm?

Urographic diagnosis of the kidneys may be accompanied by adverse reactions organism, which usually manifest themselves in the following:

• A burning sensation in the vein where the contrast was injected;
• Feeling of nausea;
• Hot flashes;
• Dizziness;
• Iron taste in mouth.

But such reactions are considered normal and soon disappear on their own. In order for the contrast to leave the body faster, it is recommended to drink more liquids such as fruit juices, green tea or milk. If there are no contraindications to urographic diagnosis of the kidneys, then there are no side effects doesn't happen, but possible harm comes down to only short-term x-ray exposure.

Urography in children is a safe procedure; it is performed in them in the same way as in adults, only the dosage of contrast is determined with particular rigor based on the child’s weight and the condition of his kidneys and liver. Because small children cannot long time remain in a motionless state, then their X-ray contrast diagnostics is carried out with a shorter time interval. To eliminate the possibility of an allergic reaction, children are additionally given antihistamines.

results

When assessing the results of urography, the doctor analyzes the location and shape of the kidneys, and also notes the rate of removal of the radiocontrast substance. Parenchymal structures are assessed, pyelocalyceal system and its functionality. Obstacles to normal urinary flow, insufficient filling of the pelvis with urine, etc. are identified.