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Urography is an X-ray examination of the urinary system, which allows you to see both the kidneys, bladder and ureters thanks to the administration of contrast. What are the indications for urography? What is the X-ray of the kidneys with contrast and what are the complications?

Urographyis still the primary method of diagnosing urinary tract diseases. But not the only one. Typically, diagnosis begins with an ultrasound (ultrasound). If this test shows abnormalities, a urography should be performed. Although it is not always possible to diagnose the disease thanks to it, sometimes other, complementary analyzes are needed, but the information obtained allows the urologist to plan the further course of the procedure.

Urography: indications

The indications to be carried out result primarily from disorders of the urinary system, which may be caused by abnormalities in the production, flow or removal of urine. They include, among others :

  • congenital and acquired urinary tract defects
  • suspected abnormal shape of the kidneys, ureters, bladder
  • renal blood supply disorders
  • injuries of the pelvis, abdominal cavity (if no other tests are available)

In addition, urography allows you to assess the secretory function of the kidneys, it is also used as an auxiliary examination when the ultrasound or computed tomography image is ambiguous.

Urography: preparation for the examination

You need to prepare for urography. On the day of the test, you should be fasting, and on the previous day, you should take a laxative so that the digestive tract is not filled with either food or gas.

Even before that, the patient has to perform specific blood tests, i.e. to determine the level of creatinine and urea. Both of these indicators indirectly reflect kidney function. When going to urography, you need to take the results of these analyzes with you.

Urography: the course of the study

The urinary system is a group of organs whose task is, generally speaking, to pass urine efficiently. The system includes the kidneys, ureters, bladder, and urethra.

In order to obtain an image of the structure (morphology) of these organs and their functioning, a series of x-rays are taken. The image on the film is created only when the patient is given a contrasting agent, i.e. contrast.

I'm gettingit goes along with the blood to the kidneys, and then to the urine, with which it passes to further parts of the urinary system. Doctors then talk about contrasted urine. The first photos are usually taken at 5, 10, 20, 30 and one hour later. In some cases, your doctor may decide to retake the images after 6, 12, and 24 hours.

The first pictures (nephrographic phase of the examination) show the kidneys: their number (two, only one or more than two), position (normal or incorrect) and shape. They also show the presence of some stones, the so-called non-shading.

In the next excretory phase of the test, you can also observe whether both kidneys are passing urine at the same time, or if there are any obstructions that are blocking the free flow of urine into the bladder.

Contrast, filling the cup-pelvic systems in the kidneys, provides information about their structure and about the outflow of urine through the ureters to the bladder.

At this stage, the test shows what is not visible on ultrasound - the ureters. Sometimes they are widened (due to the obstructed outflow of urine) and arched or bent, which sometimes causes urine to accumulate there and cause inflammation. Occasionally a stone is found in the ureter that blocks urine from flowing freely into the bladder.

In the final phase of the test, high-contrast urine fills the bladder. The photo shows the outline of the bladder, its walls - smooth or thickened - possible diverticula, tumors, a shadow of an enlarged prostate. You can also check if urine remains in the bladder after voiding.

Urography: complications

After administering the contrast, patients often complain of a sudden feeling of warmth or even hotness, itching of the skin, nausea, and sometimes vomiting.

In extreme cases, a sudden drop in blood pressure may occur, and life is extremely rarely endangered.

The fact that the urinary tract is visible on X-rays depends on the presence of iodine in the contrast. Iodine strongly absorbs X-rays.

Contrast is an organic compound of iodine dissolved in water. The body does not absorb it, but almost 100 percent. excretes with urine. Urography is not recommended for people who are allergic to iodine or have toxic goitre of the thyroid gland.

If the patient has had a contrast test before and has experienced disturbing reactions, be sure to tell both the referring doctor and the staff who performs the test.

A very rare complication of urography that affects people with pre-existing renal insufficiency may also be contrast nephropathy - acute kidney damage caused by a contrast agent. After two or three daysthe level of creatinine in the blood increases with the administration of contrast - fortunately, the intravenous administration of the contrast agent (as opposed to the administration into the artery), this damage to the kidneys is temporary.

Important

Urography is usually done in hospital clinics that have an X-ray machine. The necessary condition to be met is the presence of an anaesthesiologist during the examination, who can always be asked for help in the event of a sharp reaction of the patient to the given contrast. The result of the examination is a set of x-rays and a description made by the radiologist.

If urography does not give a specific result, the doctor usually orders a scintigraphy. In such a situation, urography is admittedly basic, but only one of several tests that must be carried out in order to make a final diagnosis.

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