Intravenous pyelogram (IVP)

An intravenous pyelogram (IVP) is an imaging test that uses a type of dye (contrast medium) called radiopaque iodine and x-rays to produce images of the urinary tract (kidneys, bladder, ureters and urethra). The dye collects in the urine (pee). The x-rays show the size, shape and position of the urinary tract and if there is a mass or stone blocking it. The IVP also shows how well the kidneys work and how well the bladder empties.

An IVP is also called an intravenous urography (IVU) or excretory urography.

An IVP may be done to:

• see changes in the size, shape and position of the urinary tract
• find the cause of abnormal symptoms such as blood in the urine, pain in the side or lower back, or frequent urinary tract infections (UTIs)
• diagnose kidney disease, stones in the urinary tract, infection and cancer
• assess damage caused by trauma

An IVP is done in the x-ray (radiology) department of a hospital or clinic. You usually don’t stay overnight. The test usually takes 1 hour, but it may take longer.

Before you have an IVP, it is important to tell the doctor if you are pregnant or think you may be pregnant. It is also important that you tell the doctor if you are breastfeeding.

You may be asked to:

• not eat or drink anything for 12 hours before the test
• take a laxative the evening before the test
• have an enema the morning of the test
• have a blood test to make sure the kidneys are working well enough

You will be asked to remove clothing, jewellery and other objects that will be in the x-ray field and may interfere with the quality of the x-ray. You will lie on your back, and an x-ray of your abdomen will be taken to make sure the colon is empty and to see the location of your kidneys.

The dye is given through a needle into a vein in your arm. You will be asked to stay very still and possibly hold your breath while the x-rays are taken. At least 3 x-rays, several minutes apart, are taken as the dye travels through the urinary tract. You may be asked to turn from one side to the other or to hold different positions so other x-rays can be taken. The final x-ray is taken after you urinate. An x-ray that projects the motion or activity of internal organs onto a screen (called fluoroscopy) may be used during an IVP.

After the test, drink plenty of fluid to help flush the dye from your body.

X-rays use very low levels of ionizing radiation. Ionizing radiation is strong enough to damage cells in our bodies and increase the chance of developing cancer. X-rays are strictly monitored and controlled to make sure they use the least possible amount of radiation. Even with multiple and repeated x-rays, the total dose of radiation and the associated risks are small. The benefits of having an x-ray outweigh the risk of exposure.

On rare occasions, the dye may cause an allergic reaction. It can also cause kidney damage if the kidney is not working properly. Elderly people, people with diabetes or people with previous kidney problems may need to take special precautions.

The radiologist examines the pictures and prepares a report for your doctor. Your doctor will talk to you about the results and may recommend more tests, procedures, follow-up care or treatments.

IVP is not commonly used with children. Preparing children before a test or procedure can help lower their anxiety, increase their cooperation and develop their coping skills. This includes explaining to children what will happen during the test, such as what they will see, feel and hear.

Preparing a child for an IVP depends on the age and experience of the child. Find out more about helping your child cope with tests and treatment.