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What is an Intravenous Pyelogram (IVP)?

Male Urinary Tract
Male Urinary Tract
Medical Illustration Copyright © 2015 Nucleus Medical Media, All rights reserved

Female Urinary Tract
Female Urinary Tract

IVP is an x-ray exam that uses a special dye to outline the kidneys, ureters and bladder. It can show how your renal and urinary system handles fluid waste. This helps your health care team find problems in the urinary tract.

IVP is used to diagnose why a patient has blood in their urine, or pain in their side/lower back. It can also show us how each person's unique kidneys and urinary system is made. It can find:

The dye shows up well on the x-ray and outlines your organs.

When is IVP Used?

Before computed tomography (CT) imaging was widely available, IVP was very common. It would be used to check:

IVP isn't used as much today, but it's still sometimes helpful.

CT has become the x-ray study of choice for the urinary tract. CT can rapidly (even in a single breath) make an image of the entire area. A CT scan shows a cross-sectional view of the patient. In some cases, a CT study doesn't need to use a contrast agent. It can often provide better information than an IVP. However, it does result in an increased amount of radiation.

Procedure

An IVP is most often done in a hospital or a doctor’s office. It is done by an x-ray technician with a doctor’s oversight.

You’ll likely be on a restricted diet 24 hours before to the test. You’ll be asked to urinate right before, to make sure your bladder is empty. Then you’ll be asked to lie on your back and remain still.

An x-ray, also called a "scout" film, will be taken of the abdomen and pelvis before the contrast agent is used. This helps to make sure that the x-ray machine is set for your size, and that there are no small stones present. The contrast agent is then injected into your vein. A series of x-rays are taken to see the contrast material filter through your kidneys. Once the agent has moved through the kidneys, it will pass down the ureters into the bladder. X-rays are taken throughout to follow the path of the contrast agent. The x-rays will be reviewed for evidence of tumors, cysts, stones, or other structural and functional abnormalities.

At the end of the study, you’ll be asked to urinate so that a final set of images can show how well your bladder empties. Once the IVP is over, you can immediately resume your daily activities.

Risks

The main risk of an IVP test is a reaction to the dye. Such reactions are not common. Reactions occur in anywhere from 3 to 13 out of 100 people having an IVP. In general, reactions are minor, and consist of:

  • Feeling flushed (a sudden, temporary reddening of the face, neck or chest)
  • Nausea
  • Vomiting

These are often treated with antihistamines (drugs that reduce the histamines in your body from an allergic reaction).

In very rare cases, more severe reactions can occur. These can include:

  • Breathing difficulties
  • Low blood pressure
  • Swelling of the mouth or throat
  • Cardiac arrest

Risk Factors

Some people are more likely to react badly to the dye than others. Some risk factors include:

  • History of allergic reactions (such as hay fever, asthma or hives)
  • Congestive heart failure
  • Diabetes

In these cases, you may be given antihistamines or steroids before the exam. This will reduce a reaction to the x-ray dye. Also, the use of a "non-ionic contrast agent" may have a lower risk of allergic response.

More Information

What is my risk for radiation exposure during Intravenous Pyelogram (IVP)?

Radiation exposure from an IVP is relatively low. But if you’re pregnant (or think you may be pregnant), you should tell your health care provider before the test. This is because a fetus should not be exposed to any radiation, if possible.