Examining The Process Of Intravenous Urography Biology Essay


Intravenous urography is an examination where the doctor can check to see the system and urine in the patients body. Normally, this examination uses a special dye or contrast medium allows the anatomical structure urinary organs can be seen on x-ray film. Additionally, the IVU is a procedure to check whether the structure of the kidney is functioning properly diagnose the problem and also the kidneys, ureters, bladder and urethra by using contrast media.

This examination usually involves the use of contrast media is inserted or injected into the patient through a vein and travels through the veins or blood vessels.

This procedure has some similarities and names, among them:

1. intravenous urography

2. urography

3. pyelography

4. antegrade pyelography

5. nephrotomography

anatomical structures involved in the IVU: -

1. kidney pair

2. a pair of ureters

3. bladder

4. urethra


Indications for IVU

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1. had renal calculi (kidney stone)

2. recurrent infections; focus, damages, (if associated with other symptoms)

3. polycystic kidney disease

4. pyelonephritis

5. hydroneprosis

6. obstraction of renal

7. trauma

8. hematuria

9. renal colic

Contra indications is a condition which makes a particular treatment or procedure inadvisable. A contraindication may be absolute or relative. contraindications that may occur in the following IVU:-

- General signs contrary to contrary to water-soluble agent.

- Hepato renal syndrome

- Thyrotoxicosis

- Pregnancy (allowed only 28 days of birth)

- Raised blood urea above 12 mmol / L urography is not likely to be successful.

- Anuria

- Multiple myeloma

- Diabetes mellitus

- Congestive heart failure

- Uncontrolled diabetes.

Patient Preparation for IVU Examinations

Early preparation.

Determining the types of physical and psychological preparation. For patients with children (3-12 years), parents should play a role and encouraging the child to undergo IVU as often in children this age, the fear of things like injections, alone in the room x-ray , fear is disturbed by your doctor or nurse is normal. Parents should also make sure their children are ready to test IVU. While for adult patients, the explanation is uncertain and security of the doctors will be given primarily to those who doubt.

For normal people, things that should be examined are:

1. IVU test prior

2. internal abdominal injury

3. taking drug therapy

4. Allergic

5. rate of urea in the blood (the normal: 2.5-6.5 mmol / L)

If patients do not want to undergo this test, the results of the patient must be respected. notwithstanding, the privacy and rights of patients must be observed and protected by the health authorities (radiographers, doctors, etc.)

fixing the date of initial appointment and the test should be conducted to ensure that patients receive early information about the procedure for patients can be prepared in advance and radiation tests can be conducted smoothly. Make sure the patient's medical history review, identify allergies (if any) and the menstrual cycle of patients. This aims to prevent anaphylactic shock effect and facilitate the doctor and the chief x-ray contrast media are looking for, together with the patient. These measures should be taken seriously on those who are allergic to iodine. as a radiographers, is an obligation to remind the patient to fast for 8-12 hours before the procedure. If necessary, the quantity of food intake in the low and high fiber is allowed. But if the patient has diabetes or not to fast (on the advice of a doctor), the procedure for such patients should be undertaken immediately. Patients are also entitled to be supplied saline / laxative (bowel drug) and instructed to eat the day before testing to remove all air and digested in the intestines and digestive organs to facilitate the image of the kidney and urinary excretory duct can be seen clearly. Patients must sign the letter of agreement as a sign of understanding and agreed to undergo IVU.

During the test

When patients arrive at the appointed date, radiographers should be prepared, and the contrast media tools that are appropriate to the patient. radiographers will play a role in ensuring that patients are willing to (follow directions) and IVU test went smoothly. patient's blood pressure will be checked in advance to check the condition of the kidneys. patients are asked to change clothes on a hospital gown and radiopaque items such as jewelry, cell phones, watches, underwear and all metal must be ensured is isolated from the patient to avoid interference in the image of the film. after changing the patient first asked to lie down and relax before the contrast media into the blood vessels / veins. In this examination, the procedure will take approximately 40 to 60 minutes.initially, radiographers will take x-rays at the patient's abdomen without contrast media. thereafter, the radiographers will introduce contrast media into the venous vessels in the arm. After that, the process of taking x-rays which would be done on the abdomen and pelvis. Currently, the patient will be asked to hold your breath for a few seconds.

Radiation Protection

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Direct lead rubber gonad protection is used with the 'apron partial' or shield of Kings Lyn when the anatomy involved gonad structure. In addition, the reduced dose, kVp and mAs are given to patients in order to reduce scatter radiation. Make sure the inspections go smoothly and perfectly that once again does not need to be done, and it can reduce excessive doses received by patients.

injection of contrast media

line median cubital vein is injected with a 19 gauge needle with a temperature of 40 degrees Celsius (40 * C) and rapidly injected with a needle. The films were then taken at regular intervals to show the whole of the renal tract.


main constituents

Iodine mg/ml



Niopam 300





Omnipaque 350





Urograffin 370







Selection factor

Omnipaque - 350 (Iohexol - LOCM)

The volume of 50-100 ml (adults) or 2 ml / kg or according to the instructions radiologists.

Readily available, the risk of allergic reaction is less, and easily excreted by the body.

Visipaque - 300 (LOCM)

Volume of 50 ml of adults or 1 ml / kg or according to the instructions radiologists.

Able to opaque entire vascular system of KUB and much better than omnipaque and iopamiro.

Iopamiro - 300 (Iopamidol - LOCM)

The volume of 50-100 ml (adults) or 2 ml / kg or according to the instructions radiologists.

Readily available, the risk of allergic reaction is less, and easily excreted by the body.

end of injection, (24 x 30cm) anterior posterior (AP) of the renal area showing the whole of the renal tract.


there are six projections to be taken in the IVU examination:

1. prelim film

2. immediate film

3. 5 minute film

4. 10 minute film (i compress)

5. film release

6. film post-mict

AP prelim KUB film (14 x 15 inches)

1. for colon and structural inspections.

2. to identify the position of the renal.

3. to determine the exposure factor

4. to see the pathological abnormalities.

AP immediate AP Renal film (10 x 12 inches)

1. 50ml of contrast medium injection.

2. taken immediately after the injection is made.

3. to show proof of phase nephrogram renal parenchyma (tissue in the kidney).

5 minute film, Ap KUB (14 x 17 inches)

1. to see the symmetry in the excretion of both kidneys.

2. shows the pelvis.

3. difference after the flow of contrast agent by the renal

4. injection of contrast media will be granted if the kidney is less visible.

10 minutes of film (I compress) AP Renal (10 x 12 inches)

1. Compression can be used in some centers to be tight at this point pelvic calyces systems to demonstrate any defect core and a film taken at 10 minutes for the renal area.

2. 15 minutes after injection

3. to show the density of the pelvis with contrast agent system.

4. to prevent contrast media over the ureter.

Emphasis is opened (film release) AP KUB (14 x 17)

1. after the stress is released

2. to see the flow of contrast medium filling the entire ureter

Post-mict film (KUB)

1. after the bladder is emptied, the patient needs to urinate in the toilet.

2. to assess the patient's residual urine after urination.

3. to assess the ability of the ureter or bladder emptying.

4. look for abnormalities such as bladder tumor, calculi.

Patient Care After The Procedure

First of all, make sure the patient is in a stable. After that, make sure the patient understands any preparation instructions are complete. check the patient's understanding of how to accept the decision, then direct the patient can change their clothes. patients will return to the ward or outpatient can return to daily unit treatment.














35x43 cm

24x30 cm

Assessment of image

the film must have ID, and markers must be present and correct in the appropriate area on the film. In addition, evidence of collimation on four sides together around the convergence point. Additionally, the optimum exposure should penetrate all the filling of contrast media. Contrast of these structures should be optimized to fully describe the renal tissue and soft structures.

What are the risks to IVU?

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Intravenous urography is a safe examination. However, if circumstances permit, and you can make the best, you should be aware of adverse effects and know about risk at the end after this examination. The effect is that patients will receive radiation X-rays on their bodies. amount of radiation received by patients during urography examination is similar to a person who receives from natural radiation environment of over 14 months. The most important one is that if the patient is pregnant women and confirmed, they suggested not to undergo an x-ray because it will give your baby defect before the baby is born. So, first tell your doctor if you are confirmed pregnant.


This happened during and after this examination, the patient will experience a reaction due to the problem of lack of congenial body injection of contrast media. If patients experience irritation and shortness of breath during and after the inspection. Then be told as soon as possible to the radiographers and the treatment will be given immediately to prevent injury to the body.

Things to do in the event of a reaction to contrast media:

Ensure that patients do not panic and try to calm the patient. Provide first aid. Monitor the patient to an ECG machine.Notify the emergency unit, hemodialysis unit, and surgery to be ready to accept admission if patients with more serious patients.Inform the specialist and the doctor in charge of the patient

Criteria for assessing radiographs

• Structures that are shown.

A whole urinary system are shown (from the kidney to the bladder dista). 'Symphysis pubis' should be included in the boundaries of the recorder.

Only part of the urinary system looks at the series diopak particular radiograph taken after injection of contrast media

• Position.

illiac wing ribs are symmetrical and show that there is no rotation.

• Collimation and point of convergence

Collimation field should include the desired anatomical structure. Concentrated at the highest point of convergence in the plane of the illiac crest midsagital.

• the exposure factor.

There is no ambiguity caused by respiration or patient movement.

A technique and an appropriate exposure factors should demonstrate clearly the system of the urinary system in all the series of radiographs.

Mark R / L should look at all the serial radiographs