MOD 5 - GU System

Intravenous Urography (IVU) /Intravenous Pyelography(IVP)

to examine the kidneys, ureters, and bladder with an injection of contrast media

IVU contrast media and method of introduction

• antegrade (positive contrast)

• directly: kidneys renal pelvis is punctured and contrast media is injected

• systemically: administered intravenously

Retrograde Urography (Pyelography)

contrast media is introduced into the bladder via insertion of a foley catheter

Pyelography is done when

• To assess obstruction caused by tumors, scaring, or other pathological conditions.

• Indicated for evaluation of collecting system in patients with renal insufficiency or contrast sensitivity.

Retrograde Cystography

• radiographic examination of the bladder

• administered retrogradely through a catheter that is placed into the patient's bladder

• show the structure and function of the ureters, bladder, and urethra

Retrograde Cystography contrast media

• non-ionic organic

• reduced concentration when compared to other GU studies by 30%

Antegrade vs. Retrograde

Antegrade: following the flow of normal pathway

Retrograde: against the normal flow pathway

Ionic vs. Non-ionic Contrasts

Ionic

• forms ions in solution

• more patient adverse events

• less costly

• less opacity

Non-Ionic

• does not form ions

• less patient adverse events

• more costly

• more opacity

Contrast Media Reactions

• Hypervolemia

• Vasodilation

• BBB (contrast media in the brain)

• Nephrotoxicity (more urine output → dehydration)

Tech’s responsibility for contrast media rxns

• never leave pt unattended

• Most reactions occur within 5 min

• Document the reaction or incident on the requisition

Contraindications Cystography

• acute infection of the urinary tract (UTI)

• pregnancy

Cystourethrography

• examination of the urethra

• contrast is injected by a radiologist via a syringe into the patient's urethra

• images are taken upon filling the urethra

Male Cystourethrography

• AP supine (preliminary image): bladder and the external urethral orifice

• OBL (35-40): bladder neck and entire urethra are free of boney SI

Female Cytourethography

• preliminary AP supine: bladder and the external urethral orifice

• contrast is inj thru the urethra and imaging is obtained simultaneously

• 30-40 degree oblique: bladder neck and entire urethra are free of bones