Retrograde Urography (6/12/2024)

What is retrograde urography?

a nonfunctional examination of the urinary system

(contrast medium is introduced directly retrograde into the pelvicalyceal system via catheterization by the urologist during a minor surgical procedure)

Why is retrograde urography nonfunctional?

the patient’s normal physiologic processes are not involved in the procedure

Why are retrograde urographies performed?

• determine location of undetected calculi

• obstruction in the urinary system

• study the renal pelvis and calyces for signs of infection or structural defect

What imaging equipment may be used in a retrograde urography case?

• designated urology room

• portable machine

• c-arm

Explain the retrograde urography procedure

• pt in modified lithotomy position, with legs placed in stirrups

• urologist inserts a cystoscope through the urethra into the bladder

• urologist inserts ureteral catheters into one or both ureters

• after catheterization, imaging begins

Explain the approach of the c-arm during a retrograde urography

• at 90 degrees to the patient’s midline (from whichever side is most practical)

• centered over the patient’s bladder

• leave space to be able to move up to the kidney(s)

Explain the imaging role before the procedure starts in a urology room

• make sure equipment is on and working

• enter patient’s info into system

• detent the x-ray tube to the image intensifier

• center the patient for a KUB

Explain the c-arm power on sequence

• plug interconnect cable from monitor into c-arm

• plug power cord from monitor into wall outlet

• turn power button on

Explain the c-arm power off sequence

• place the c-arm in proper “park mode”

• turn power button off

• disconnect power cord from the wall outlet

• disconnect the interconnect cable from the c-arm

Explain the imaging role before the procedure starts with a c-arm

• make sure equipment is on and working

• enter patient’s information into the c-arm

• put c-arm into position over the patient

• center c-arm over patient’s bladder

Explain which “R” needs to be pressed when you are on the patient’s left and when you are on the patient’s right

right: both “R”s

left: no “R”s

What is the overall role of the technologist in a retrograde urography case?

to work with the surgeon to obtain diagnostic quality images throughout the procedure (be the eyes for the surgeon)

What is a pyelogram?

urologist injects a 3-5 mL of contrast directly through the catheter into the renal pelvis of one or both kidneys

What anatomy can be demonstrated in a retrograde urogram?

• renal pelvis

• major calyx

• minor calyx

• ureters