Intravenous urogram

About intravenous urogram

An intravenous urogram is a test that allows your doctor to look at your urinary system, using a special dye (contrast medium) that shows up on X-ray.

The dye is injected into one of your veins and travels through your bloodstream, kidneys, ureters and bladder before being passed out in your urine. The dye helps to show your urinary system more clearly than an ordinary X-ray. Your doctor will be able to see how quickly and efficiently your urinary system is working and how well it’s dealing with fluid and waste. 

Intravenous urogram used to be the standard test for looking at many different urinary problems, including:

  • kidney and bladder stones
  • tumours
  • cysts
  • an enlarged prostate gland
  • narrowing of your ureters

However, a newer type of test called a CT urogram is now frequently carried out for these conditions instead. Which test you have will depend on your individual circumstances and what is available at the hospital where you’re having the test.

What are the alternatives to intravenous urogram?

Depending on what you’re being tested for, your doctor may suggest an alternative imaging test. This may include:

  • a CT urogram – this involves taking a CT scan of your urinary tract before and after injection of a dye to show up your urinary system
  • an X-ray of your abdomen (tummy)
  • an ultrasound – this uses sound waves to produce an image of your urinary system
  • a standard CT scan – this uses X-rays to produce a three-dimensional image of your urinary system

Preparing for an intravenous urogram

Intravenous urogram is usually done as an out-patient procedure in a hospital radiology department. This means you won’t need to stay overnight. The test is usually carried out by a radiographer – a health professional trained to perform imaging procedures.

You may be asked not to drink for a few hours before having a urogram. You may also be asked to take a laxative before the test, to make sure your bowel is clear of faeces. The hospital will give you detailed advice before the test.

If you have diabetes, tell the radiology department when you receive your appointment. You will be given instructions about what to do before and after the test. You should also tell your doctor if you’re pregnant. Intravenous urogram may not be suitable if you’re pregnant and your doctor may suggest an alternative.

Before your test, your radiographer will ask you whether you have any allergies or asthma.
The radiographer will also discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during an intravenous urogram

The procedure usually takes about an hour. You will be asked to empty your bladder before the test.

In the X-ray room you will be asked to lie on your back on the X-ray table. The radiographer will take the first X-ray pictures of your abdomen without the dye.

The radiographer will inject the dye into a vein in your hand or arm, and take more X-rays of your abdomen. You may be asked to move position and lie on your stomach while the X-rays are taken.

To help improve the images of your kidneys, a tight band may be placed across your abdomen. You may also be asked to empty your bladder before another X-ray is taken.

What to expect afterwards

You will usually be able to go home when you feel ready. You will be able to drive if you wish.

You shouldn't have any problems passing urine or see any change in the colour of your urine after the test. If this does happen, ask your GP for advice.

Before you go home, the radiographer may tell you when you can expect to get your results.

What are the risks?

As with every procedure, there are some risks associated with an intravenous urogram. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

You will be exposed to some X-ray radiation during the test. The amount of radiation is always kept to a minimum during any test. The level of radiation you receive during a urogram is about the same as the background radiation that you would get naturally from the environment over about 14 months.

If you’re pregnant, or think you may be, tell your doctor before your appointment. Your doctor may suggest an alternative test.

Side-effects

These are the unwanted but mostly temporary effects you may get after having the procedure.

You may get a flushed, warm feeling as the dye flows round your body. You may also have some mild itching or a metallic taste in your mouth after the dye is injected. This usually passes quickly. 

Complications

Complications are when problems occur during or after the procedure.

It's possible to have an allergic reaction to the dye, though this is rare. If you have any itching or start to feel short of breath after the dye has been injected, tell your radiographer immediately. Medicines are available to treat an allergic reaction.

Can you tell me more about the risks of having an intravenous urogram?

Answer

As with any procedure there may be risks involved in having an intravenous urogram. The two main risks from having an intravenous urogram are the radiation used to take the X-ray images and the dye that is injected during the test. However, the chance of side-effects or complications from either of these is low.

Explanation

Most people have no problems during or after an intravenous urogram and side-effects and complications are unusual.

Any procedure that uses radiation can increase your risk of developing cancer. However, the chance of developing cancer from the radiation used during a urogram is low. The dose of radiation from the X-rays is small, compared with the dose you receive from natural background radiation in the everyday environment. Your radiographer will always use the smallest amount of radiation needed to get the best images to diagnose your condition.

The dye used during an intravenous urogram is called contrast medium and usually contains iodine. In a small number of people it can cause an allergic reaction, though most of these reactions are mild and only last for a short time. Very rarely, contrast medium can cause a very severe allergic reaction called anaphylaxis. This is when your airways become swollen, which makes breathing difficult.

Before you have your intravenous urogram, you will be asked a number of questions about your health and medical history to try and find out how likely you are to have an allergic reaction.

If you have asthma or have had a very severe allergic reaction to any medicine or food in the past, your doctor will discuss the urogram with you and help you weigh up the risks and benefits of having the test. Your doctor may also ask you to take medicines called steroids before the test, to help reduce the chance of a reaction. In the unlikely event that you do have an allergic reaction, every radiology department will have the medical staff and necessary equipment on hand to deal with this scenario.

Although having an intravenous urogram has some risks, without the test a serious health problem could be missed. For this reason it's important to discuss any concerns you may have with your doctor.

What is a CT urogram?

Answer

A CT urogram is similar to an intravenous urogram, but it uses a CT scanner to produce images of your urinary system, rather than ordinary X-rays. The images from a CT urogram are more detailed than those from an intravenous urogram.

Explanation

Instead of an intravenous urogram, your doctor may suggest a CT urogram, or you may have both tests done.

A CT scan uses X-rays to produce a three-dimensional image of your abdomen (tummy) and pelvis. A CT urogram is similar to an intravenous urogram, but instead of having ordinary X-ray images taken you have images taken by a CT scanner. During the test, you will have CT scans taken before and after injection of contrast medium (dye). The dye contains iodine, which shows up as white areas on the scans, helping your doctor to tell the difference between the organs and structures of your urinary system.

CT urograms are becoming more common across the UK and are more effective than an intravenous urogram at diagnosing certain conditions, for example kidney stones. However, which test you have will depend on a number of factors, including what you need the test for, what is available at the hospital where you are having the test and your individual circumstances. For instance, your doctor may recommend you have an intravenous urogram if you’re pregnant or if you need to have a number of tests, as it uses less radiation.

The radiology department will give you information about anything you need to do before you have the test.

How long will it take to get the results of the urogram?

Answer

It's unlikely that you will be told the results straight after the test, as the images from the urogram will need to be examined by a doctor. It can take up to two weeks for the results to be issued, unless you're very ill and they are needed more quickly.

Explanation

A radiologist (a doctor who specialises in using imaging methods to diagnose medical conditions) usually examines the images from the urogram before issuing a report and sending it to the doctor who requested your test. The report can take a few days to reach your doctor.

You’re likely to get the results of the test within two weeks after the procedure, unless you're very ill or the results are needed quickly. If you haven't been told the results of your test within two weeks, speak to the doctor who requested your test.