Urological imaging procedures may include abdomino-pelvic CT, fluoroscopy for viewing and positioning for urological problems, radiographs of the kidney, ureters and bladder (KUB), excretory urograms (intravenous urography-IVP) and retrograde urethrograms (micturating cysto urethrogram - MCU). These procedures involve exposure to ionizing radiations (X rays) whereas ultrasound waves and magnetic resonance imaging (MRI) involve non-ionizing radiations. This website is concerned with exposure to ionizing radiations.One of the most important breakthrough in Radiographical method is the Intravenous Urolography.
Intravenous Urography is one of the most common of all the different types of urologic studies. It is a test that is extremely useful in the medical field and is shows the arrival of radioactive substances that is directly and physically inserted into the body for healing properties.Intravenous Urography uses a dye that is injected into a vein to outline the kidneys, ureters and bladder on an X-ray. This is a non-invasive method to find of the condition or any pathological defects developing in the urinary system. A trained urologist is likely to use Intervenous Urolography if a patient comes and complains of pain in the abdominal or the side region. This test is also admistred if there is a worrying amount of blood in the urine or the patients show any stone-related symptoms. The test is also used sometimes as a screening test to make the urologist to come into awareness to order other tests for more information.
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Before the test, the patient will be asked to be on a restricted diet for 24 hours and asked to urinate right before the test to ensure that the bladder is empty. The patient then lies on his or her back and is asked to stay still. An X-ray will be taken of the abdomen and pelvis without dye. This helps to determine the proper technique and positioning. The doctor also first may order some X-rays of the kidneys. The patient is then injected with a dye, usually through the arm veins. As the dye travels through the bloodstream to the kidneys, it's normal for the patient to feel a warm rush. The dye will go through the kidneys, and the kidneys will filter the dye out of the blood and send it down through the ureters into the bladder.
While this is happening, X-rays are taken at specific time intervals, from 2 to 10 minutes. These X-rays will show any tumors, cysts, stones or other structural or functional abnormality. At the end, the patient is asked to urinate for final images to see how well the bladder has emptied. The entire test can take up to an hour and is not uncomfortable.
When it's over, the patient can immediately resume normal activities.
Before getting deeper into the topic of discussion, first it is best to explain the term clearly to avoid any confusion. term clearly to avoid any confusion. Firstly Intravenous therapy or IV therapy is the giving of solid substances directly into a vein. The word intravenous simply means "within a vein" or inside the vein. Therapies administered intravenously are often called specialty pharmaceuticals. It is commonly referred to as a drip because many systems of administration employ a drip chamber, which prevents air entering the blood stream (air embolism) and allows an estimate of flow rate.
Intravenous injection is known as shooting, banging, mainlining (when large veins are used, especially those of the arm), shooting up, jacking up, whacking up, IV, &c. Users determine whether they are in a blood vessel by looking for a "register"; often this is by pulling back on the plunger although the pressure of blood can cause it to shoot up into the barrel of the syringe and those made of clear materials are often called "self-registering."' Use of a tourniquet encourages self-registration by raising blood pressure in the injection area.
Intravenous therapy may be used to correct electrolyte balances, to deliver medications, for blood transfusion or as fluid replacement to correct, for example, dehydration.
Compared with other routes of administration, the intravenous route is the fastest way to deliver fluids and medications throughout the body. Some medications, as well as blood transfusions and lethal injections, can only be given intravenously.
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Certain common pathological defects which may need the aid of intervenous urography is Genitourinary tract obstruction (i.e. phimosis, hydronephrosis), Genitourinary tract infection (i.e. prostatitis, cystitis), Genitourinary tract malformation (i.e. vesico-ureteric reflux, hypospadias), Genitourinary tract growth (i.e. bladder cancer, kidney cancer), Voiding problem (i.e. prostate enlargement, stress incontinence, neurogenic bladder), Erectile dysfunction, Male infertility and even Scrotal disorders (i.e. hydrocele, varicele, orchitis, testicular cancer). Generally these conditions would either affect the quality of life adversely or pose as a threat to life due to the malignant process.
It must be noted that in men, the urinary system overlaps with the reproductive system, and in women the urinary tract opens into the vulva. In both sexes, the urinary and reproductive tracts are close together, and disorders of one often affect the other. Urology combines management of medical (i.e. non-surgical) problems such as urinary tract infections and benign prostatic hyperplasia, as well as surgical problems such as the surgical management of cancers, the correction of congenital abnormalities, and correcting stress incontinence.
The main risk in IVP is a reaction to the dye. This happens 3 to 13 percent of the time. Minor reactions include hot flashes, nausea and vomiting. The doctor would then give antihistamines, and the patient typically feels better. Antihistamines are drugs that reduce the effects of an allergic reaction. In very rare circumstances, more severe complications - breathing difficulties, low blood pressure, swelling of the mouth or throat, and even cardiac arrest - can happen. Statistics estimate these major reactions occur in about 1 out of 200 to 2,000 patients.
Patients with certain health factors - a history of hay fever, asthma or hives - are at greater risk, as are those with congestive heart failure, diabetes or a prior reaction. Giving the patient antihistamines or steroids before the exam may prevent any reaction. Also, there are new non-ionic dyes that have lowered the incidence of these reactions.
There is relatively low radiation exposure during this test; however, a patient who is or may be pregnant should tell the physician before this test, because a fetus is susceptible to the risks associated with radiation.
X-rays have been used to diagnose diseases in the kidney and urinary tract for about a century to visualize urinary tract to highlight a kidney stone or tumour that could block the flow of urine. It was only couple of decades ago that urologists started using X-ray fluoroscopy in their operating rooms. Then came lithotripsy and now it is computed tomography (CT) that is increasingly being used. CT is currently the most sensitive and specific imaging test for urolithiasis. The improved diagnostic accuracy of newer generation of CT scanners coupled with speed and patient friendliness is making CT a useful tool in follow-up of cancer patients (such as testicular) and there are situations when a patient is subjected to more than 10 CT scans in a follow up period of 5 years. Urological procedures like intravenous pylography (IVP) or intravenous urography (IVU) are generally performed using radiography machines. These investigations may or may not have a direct involvement of the urologist. However, active involvement of the urologist with the use of radiological facilities is in cystography, retrograde pyelography, voiding cystourethrogram (VCUG) procedures where there is a need to administer contrast agents directly into the urinary system. A number of procedures like percutaneous nephrolithotomy (PCNL), nephrostomy, stent placement, stone extraction and tumor ablation require fluoroscopy machine in the operating room.