How is urography performed? Side effects of contrast urography

Kidney disease remains very common today. They are used to diagnose various methods- moreover, more modern ones, for example, ultrasound and magnetic resonance imaging - are gradually replacing outdated and less informative ones. Nonetheless, x-ray examination kidney, also known as urography, is still in demand due to the fact that it allows you to learn about changes in the structure of the organ and make the correct diagnosis.

Types of urography

There are several types of x-ray examination of the kidneys. Which method to use in each specific case, decides . The doctor must choose the best way to study the tissues of the kidneys and their functionality, depending on what kind of violations are present.

This procedure is prescribed to the patient if the doctor saw any evidence of kidney disease. As a rule, it precedes all others, more complex research. Plain urography is a regular x-ray of the part of the body where the kidneys are located.

Particularly informative this diagnosis it cannot be named, but it can be used to check the location of the organ, as well as to identify large stones and some other problems. The indisputable advantage of this method is the fact that this study does not require any additional equipment, but it is carried out in any clinic. This method requires some preparation of the patient, which will be discussed below.

Plain urography allows a specialist to consider the structural state of the kidneys, starting with their upper division before the beginning of the excretory canal of the bladder. In addition, the doctor sees the bones of the pelvic region, and can also “as a first approximation” assess the condition and performance of the ureters and bladder.

Intravenous diagnostics

Intravenous urography This is an X-ray examination that involves the use of a contrast agent. As a rule, it contains iodine and. This solution is injected into the patient's vein, provided that his bladder is empty. After that, several pictures are taken.

Preparation for intravenous urography is that the patient must empty the bladder. In total, there are three methods of intravenous urography: excretory, compression and infusion.

Excretory urography

Much like a review. The only difference between these diagnostic methods is that the excretory study uses contrast agent. The first picture is taken one to two minutes after its introduction, the second after five minutes, and the third after seven minutes. The study allows you to assess the intensity with which the bladder and renal pelvis are filled with fluid, and also allows you to evaluate the shape and structure of the kidneys, the location of stones and cystic tumor neoplasms.

Compared to survey urography, the method is more informative, and the picture itself is more clear. Among the disadvantages of this technique is the possibility of an allergic reaction to contrast agents. Doctor in without fail should find out if the patient suffers from an individual intolerance to any drugs. Even if the answer is negative, a test is performed before the injection of the substance: 0.1 ml of a contrast agent solution is injected intradermally into one forearm, and into the other forearm - saline. Then the doctor compares the reaction.

Compression urography

This type is a more complex procedure. During it, the patient's ureters are artificially clamped. The image is very clear, however, it is impossible to assess the condition of the ureters on them due to the fact that they are clamped. Therefore, experts recommend combining the compression method with the excretory one, so that the result is as informative as possible. A significant drawback of the procedure is the fact that this research method is very painful.

Infusion urography

Usually given to people with handicapped and also for those who cannot move. A contrast agent is injected through the catheter, and the study is performed on the patient in a supine state.

Depending on where exactly the contrast agent is injected, urography is retrograde and antegrade. In a retrograde study, a contrast agent is injected directly into the ureters under general anesthesia. After that, an overview urography is performed. This method makes it possible to study the ducts as clearly as possible.

In antegrade percutaneous urography, a contrast agent is injected through skin in upper part ureters. Going down them, the drug enables the doctor to study them properly. This method allows you to identify ruptures of the ureters, inflammation, neoplasms.

Each of the above methods has its own advantages and disadvantages. So, survey urography is fast and does not require the introduction of contrast, however, it cannot boast of high information content. With an excretory study, the image is not very accurate, but this method is simple and reliable. Compression urography also does not take much time, but the procedure is very painful. Infusion therapy is suitable for people with disabilities, but requires a lot of time due to the need to be under a drip. Retrograde and antegrade methods provide an exhaustive amount of information, but require general anesthesia.

Possibilities of survey urography

The main purpose of an overview x-ray examination of the kidneys is to identify stones at different levels. urinary system. These can be stones in the kidneys, bladder and ureters. However, it should be taken into account that this method allows you to visualize not all types of stones, but only stones of urate and oxalate origin. Phosphate neoplasms in the pictures are most often invisible. In addition, the picture shows tuberculous foci and echinococcal cysts.

Also, using this method, the doctor can identify other pathological processes based on the data obtained. So, visualization of the kidney shadow will allow us to draw a conclusion about the size of the organ and its location. Based on the outlines of the lumbar muscle, one can judge the state of the surrounding kidneys. The doctor may also examine the lumbosacral spine, hip joints, the lower edges of the ribs, as well as the pelvic bones.

Indications and contraindications

As noted above, survey urography is the first procedure to which a patient is referred for suspected pathological processes in the kidneys.

The indications for the study are:

Congenital or acquired hydronephrosis of one or both kidneys.
Stones in the urinary tract: in the tissues of the kidneys, bladder and ureters.
Availability foreign bodies in the urethra or in the lumen of the bladder.
Lower back injuries, including torn back muscles.
Tumors and other pathological foci (cysts, abscesses, etc.).
Abnormalities in the development or location of the kidneys

At the same time, like any X-ray examination, the procedure has its own contraindications. Thus, the study is not carried out on pregnant women, patients suffering from radiation sickness, as well as those who had one kidney removed, and the functionality of the second was impaired.

In addition, they try not to refer patients to urography who have recently undergone a study of the gastrointestinal tract with barium suspension. This is because barium remaining in the body significantly impairs visualization of the kidneys and urinary tract. Therefore, the interval between studies should be at least a week in order for the barium suspension to completely leave the body.

What can a survey urography show

This diagnostic method, as noted above, is initial stage study of the condition of the kidneys. The doctor prescribes this procedure if he has suspicions about the dysfunction of the organ or the presence of some pathological processes in it.

So, survey urography helps to identify:

Benign or malignant neoplasms
Changes in the structure of the organ tissue.
Stones.
Anomalies in the structure of the kidneys.
Pyelonephritis, glomerulonephritis, hydronephrosis, kidney tuberculosis.
Causes of blood in the urine.
Possible complications after surgery.

How to take a picture

There are several principles that must be followed in order for the x-ray image to be as informative as possible and for the specialist to be able to diagnose the pathological process.

First of all, you should not take an x-ray of only one kidney. Doctors are aware of situations where changes in location pain syndrome cannot be detected, and violations are detected in the opposite organ.

A high-quality image is considered to be the one that maximally covers all the structures that are components of the urinary system: the kidneys and ureters and the bladder. Also, the picture should contain the contours of the eleventh and twelfth ribs and the upper edge of the pubic articulation. A film measuring thirty by forty centimeters should be used.

How is the procedure carried out

Survey urography - the procedure is simple and does not take much time. Immediately after the patient enters the office, he is asked to remove Jewelry and metal objects. After this, the patient is asked to lie on his back, a pillow is placed under his head. The x-ray beam is directed strictly perpendicular to the surface of the body, a few centimeters below the xiphoid process. Immediately at the time of the picture, the patient must hold his breath. This will help to avoid "double" images.

Special training

In order for the results to be as reliable as possible, the patient must prepare in advance for it.

So, it is often normal to visualize the processes that occur in the organs of the urinary system, sometimes swollen intestinal loops interfere. Therefore, it is extremely necessary to cleanse it of feces in advance.

To this end, patients are asked at least three days before the study to exclude from the diet food that can provoke flatulence. These are white flour bread, cereals and legumes, dishes from, fruits and dairy products.

Dinner the night before should be light. Sit down at the table should be no later than six o'clock in the evening. On the day of the urography, it is better to refrain from breakfast.

Refrain from using a large number liquids. On the day of the study, you can drink a glass of unsweetened tea.

Features of the procedure for children

The method of conducting survey urography for children is no different from how adult patients are examined. It is not recommended to conduct a study of babies under the age of one month.

Note that when performing urography with a contrast agent, you should carefully calculate the amount of the drug for small patients.

However, even when conducting survey urography, which is absolutely painless, parents should prepare the child in advance and explain to him that he will not experience discomfort, and therefore should not be afraid.

Algorithm for describing the resulting image

The first step in describing a snapshot is to examine the state skeletal system. The thing is that pathological processes in the organs of the urinary system also affect the bones. So, for example, when chronic diseases kidneys, there is a so-called "compensatory scoliosis" of the spine towards a healthy organ.

In the event that the patient has carefully prepared for the procedure, the shadows of the kidneys are clearly visible in the picture. The norm is the location of the left kidney at the level of the twelfth thoracic and up to the second lumbar vertebral bodies, and the right kidney - from the first to the third lumbar vertebral bodies. What right kidney located below the left, due to the fact that the liver presses on it.

Describing the shadows of the kidneys, the specialist should indicate their shape, size and state of the contour, as well as comment on the density of the tissue of the organ.

The doctor is also interested in the condition of the lumbar muscles, their contours and symmetry. Any changes may indicate that an inflammatory process occurs in the retroperitoneal space or there are tumor foci.

As a rule, normal ureters are not visualized because they are hollow. If there is inflammation in their lumen or calculi are present, then the images show shadows that correspond to the location of the ureters.

Bladder visible in the picture if concentrated urine is present in its lumen.

After the specialist has compiled a description of all the "natural" shadows and structures, he begins to study pathological and additional shadows that may indicate dysfunction in the body.

An alternative to survey urography

Despite its popularity, urography is considered an obsolete research method. Almost the same functions today are performed by ultrasound and MRI. They allow you to explore everything. internal organs, reveal inflammatory processes, tumors and calculi in the kidneys.

Urography is a radiopaque study of the function of the kidneys and urinary tract, which is used to diagnose most urological diseases.

The resulting urogram perfectly visualizes the anatomical position of the kidneys, their shape and size, allows you to assess the degree of functionality of the urinary organs, detect a variety of pathologies (neoplasms, stones, foci of inflammation).

Urography happens:

overview - without the introduction of contrast, in fact it is an x-ray of the kidneys and urinary tract;
excretory (intravenous) - a contrast agent is used, which is administered intravenously. This is done for better visualization.

As a contrast in excretory urography, iodine-containing preparations are used. Iodine is a substance that can cause an allergic reaction varying degrees gravity. Therefore, 1-2 days before the examination, a test for individual sensitivity to iodine is required. Testing is performed in an outpatient setting under the supervision of medical staff. With the development of allergies (urticaria, runny nose, swelling), the patient immediately receives qualified help. In this case, the introduction of a contrast agent is strictly contraindicated.

Preparation for urography

Within 3 days before urography, it is necessary to follow a diet that excludes foods that cause fermentation and gas formation in the intestines (vegetables, fruits, dairy products, carbonated drinks, black bread, etc.).

If necessary, a cleansing enema and reception may be prescribed on the eve of the procedure. activated carbon.

8 hours before the examination, you can not eat or drink a lot of liquid.

Immediately prior to urography, the bladder and stomach must be empty.

Indications

Urography is used to diagnose diseases of the urinary system and is prescribed by a urologist if there are certain indications:

chronic infections of the urinary system;
hematuria (blood in the urine);
urolithiasis disease;
obstruction (blockage) of the ureter;
congenital anomalies of the kidneys;
pathological mobility of the kidneys;
traumatic injuries;
control after surgical treatment.

Contraindications

Conditions in which urography is not desirable or completely contraindicated include:

allergy to iodine-containing drugs;
pregnancy at any time;
various bleeding;
decreased blood clotting;
renal failure (acute or chronic form);
glomerulonephritis (acute course);
thyrotoxicosis;
therapy diabetes drug "Glucophage";
pheochromocytoma (hormonally active tumor of the adrenal medulla).

If it is not possible to perform urography (if there are contraindications), this method can be replaced by others, less informative, but safer for specific person research: ultrasound kidneys and bladder, CT or MRI.

The decision on the advisability of replacing or supplementing one diagnostic method with another is made by the attending physician, based on individual features sick. In any case, all examinations are aimed at obtaining as much reliable information as possible about the condition of the kidneys and urinary tract.

The accuracy of the diagnosis and the effectiveness of the prescribed treatment depend on the completeness and quality of the information.

Urography technique

It is better to undergo urography in those clinics that specialize in the diagnosis and treatment of urological pathologies.

Before the examination, it is necessary to sign an official consent to conduct urography. This can be done by the patient himself or his relatives. Then you need to remove all metal objects from yourself and change into disposable medical clothes. If the patient is worried severe pain or a feeling of fear, he may be offered sedatives and painkillers.

Before the introduction of a contrast agent, an overview urography is performed - an x-ray of the kidneys and urinary tract.

Excretory (intravenous) urography

Shooting begins in the first minutes after the contrast has entered the blood, and lasts from 45 to 60 minutes. During this time, several shots are taken at regular intervals, for example, 5-7 minutes, then 12-15, 20-25, etc.

When the contrast is slowly removed, delayed shooting is possible (at 45, 60 minutes). How many pictures you need to take is determined by the radiologist, taking into account the characteristics of the disease.

Side effects

Often during the injection of a contrast agent, patients feel a burning sensation along the vein, nausea, dizziness, or a feeling of heat throughout the body. These reactions are considered normal, unpleasant symptoms pass on their own.

On a note: to speed up the process of removing the contrast and neutralize the received dose of radiation on the first day after the examination, it is recommended to drink more liquid, better milk and fruit juices.

Since a sensitivity test was made before the introduction of a full dose of a radiopaque preparation, an allergy to it develops extremely rarely.

If the preliminary examination of the patient was carried out correctly and did not reveal any contraindications to urography, then these and other side effects are usually not observed.

Urography is an effective, safe diagnostic method. The study is prescribed for suspected development renal pathologies, damage to the bladder, with problems with filtration and excretion of urine. The technique allows to identify stones, tumors, cysts, to determine the structure of the kidney tissue.

Before the procedure, patients should understand that the doctor did not accidentally choose such a method as urography. What it is? What does the study show? What is the difference between contrast urography and survey urography? How to properly prepare for the procedure? Answers in the article.

general information

X-ray examination reveals abnormalities in work important organs performing excretory, filtration and excretory functions. For a more complete picture of negative changes, the doctor first injects a contrast agent, then undergoes an examination. In survey urography, intravenous administration of drugs is not carried out. The study is allowed at any age, there are no complications and serious discomfort during the procedure.

Advantages of modern technique:

gives reliable data on the degree of kidney damage, the type of pathology;
the picture clearly shows the parenchymal structures, calculi, pyelocaliceal system;
shows the stage of the disease, the quality of the kidneys;
does not deliver to the patient pain;
there is no tissue injury;
suitable for detecting various pathologies, including congenital;
adverse reactions pass quickly enough, severe complications No;
foci of inflammation are clearly visible;
the procedure is prescribed for both adults and children;
several types of research allow the doctor to choose best option to clarify the nature of the pathology in a particular patient;
the preparation is simple, you do not need to take expensive drugs;
during the study, the patient receives the minimum dose of radiation;
urography is a highly informative diagnostic method with reliable results.

Indications for the study

X-ray examination is prescribed to identify:

small and large;
benign and malignant tumors;
hypertension that occurs against the background of renal pathologies;
causes of hematuria;
congenital pathologies of the structure of the urinary system;
infectious diseases occurring in the organs of the genitourinary system;
structural disorders in the tissues of important organs;
control of problem areas at;
to clarify the condition of the organs after kidney surgery.

Contraindications

Survey, excretory and contrast urography is not suitable for all patients. Before the study, the doctor finds out if there are restrictions for a particular person. The patient is obliged to inform the urologist about all chronic pathologies, intolerance certain substances, pregnancy.

Urography is not performed in the following cases:

acute or chronic;
pheochromocytoma;
tendency to bleed;
thyrotoxicosis, other pathologies of the thyroid gland;
low blood clotting;
pregnancy;
severe forms of kidney or liver diseases;
taking Glucophage medication during diabetes therapy;
allergic reactions to iodine contrast agents;
bleeding of various kinds;
breastfeeding period.

What to do if the doctor forbids doing urography? Alternative - more safe methods examinations: CT, MRI, . These techniques give reliable results, although the information content of urography is higher.

Types of X-ray examination

X-ray examination is carried out different ways. The choice of method is the competence of the urologist. The doctor selects the best way to study the tissues and functionality of the kidneys, depending on the nature of the violations. Survey urography is often prescribed before a contrast type of study to clarify the data, to obtain a more detailed picture of the internal renal structures.

Survey urography

Characteristics:

most x-rays are taken by physicians at the time of removal of the contrast agent;
the method allows you to reliably assess the excretory function of important organs, determine the rate of filling of the bladder, renal pelvis;
during the study, stones are clearly visible, their size, shape, location;
excretory type of study is prescribed to detect tumors,;
the method gives an idea of the structure of the organs of the urinary system.

Contrasting

Features of kidney urography with the use of a contrast agent:

to study the kidneys and bladder, a contrast agent is used, which is administered intravenously;
the technique is based on the filtration ability of the kidneys, the excretion of processed materials, the excretion of metabolic products;
as a radiopaque substance, Vizipak, Urographin, Cardiotrast are chosen;
after the introduction of the components, the patient often feels heat in the body, burning in the vein, nausea, metallic taste in the mouth. Side effects disappear after a few minutes;
contrast urography is performed with an empty bladder. Pictures are taken during the period of accumulation of a contrast agent from the blood at certain intervals: in the first 2 minutes, then after 5 minutes, 7 minutes after intravenous administration special drug;
the technique shows the pelvis, ureters, kidneys, prostate, stones, cysts, tumors. The pictures show hydronephrosis, prostatic hyperplasia, pathological stretching or wrinkling of the organs of the genitourinary system.

How to prepare: basic rules

Basic rules for preparing for urography:

three days before urography, the patient should refuse food that provokes increased gas formation: legumes, fresh cabbage, carbonated drinks, fresh bread, muffins, raw vegetables;
with a tendency to flatulence, it is important to take activated charcoal once a day in required quantity(per kilogram of weight - 1 tablet);
be sure to do a test to clarify the allergy to the radiopaque substance: Urografin, Triombrast, Visipak, Cardiotrast and others. If earlier there were cases of a negative response to the listed drugs, then the patient is obliged to warn physicians about undesirable manifestations;
no later than 8 hours before the X-ray examination, you need to eat, during the day you should not drink too much liquid;
In the morning on the day of the procedure, you can not eat;
in the office, the patient removes metal products, jewelry, empties the bladder as directed by the doctor;
with nervousness, fear of unpleasant sensations, shortly before urography, it is allowed to take a sedative (sedative) remedy.

Find out how to collect and what the results show.

A page is written about how to treat urolithiasis in men with a diet.

How is the procedure carried out

Research features:

how is urography performed? The first stage is survey urography, then excretory;
the duration of the procedure depends on the severity of the pathology, the detection of stones, the number of stones, and other factors (individual characteristics of the person);
overview urography is done in the "standing" position. To protect the chest and genitals, these areas are covered with heavy aprons with protective plates. The doctor sends a beam of x-rays to the zone 3 and 4 of the vertebrae;
for intravenous urography with a radiopaque substance, the patient lies down on a special table, the doctor injects the drug into the vein. The beginning of the procedure is sometimes accompanied by unpleasant sensations, after a short time the discomfort disappears;
gradually the contrast penetrates into the renal tissue, ureters. With excretory urography, pictures are taken at a certain interval. One shot must be assigned "standing", the rest - in the "lying" position;
in the presence of indications, delayed pictures are taken a few hours after filling the tissues with a contrast agent;
the standard duration of the procedure is from 30 to 60 minutes;
after the study, the patient can do the usual things, eat, drink liquid.

Important point! To conduct any type of study, the patient must empty not only the bladder, but also the intestines. Air bubbles, accumulation of processed products interfere with renal imaging, reduce the effectiveness of the method. If a person cannot cleanse the intestines on their own, an enema is performed to maximize the removal of food debris and gases.

Side effects

During survey urography, discomfort does not appear, discomfort for a short period occurs at the time of the introduction of a radiopaque substance. After a few minutes side effects disappear.

The doctor is obliged to warn the patient about possible negative sensations:

burning in the vein in the first minute;
nausea;
unpleasant taste in the mouth;
dizziness;
feeling of heat in the body.

For the speedy removal of the radiopaque substance, the patient after the procedure should drink more milk, natural fruit juices, weak green tea.

results

After the procedure, the doctor analyzes the images, clarifies and identifies:

shape, size, location of the kidneys;
state of parenchymal structures;
functionality of the pelvicalyceal system;
the quality of filling the pelvis with urine;
urine outflow rate;
the presence of stones;
the consequences of trauma in the urinary tract;
malformations of the kidneys;
severe degree of hydronephrosis.

Urography - modern research to assess the state of the urinary tract, renal parenchyma, identify inflammatory foci, problem areas obstructing the free flow of urine. X-ray examination is safe for patients of any age. Proper preparation to contrast, excretory and survey urography increases the effectiveness of the method.

Learn more about urography examination of the kidneys after watching the following video:

Overview and excretory urography of the kidneys - effective ways x-ray examination for the diagnosis of kidney disease. These methods are important in carrying out comprehensive research, as they are based on the study general condition and analysis of excretory functions of the kidneys. Excretory urography is a more informative way to study the organs of the urinary system.

Urography is prescribed for suspected the following diseases or pathological conditions:

kidney stones;
urinary tract infections;
inflammatory process;
oncological disease;
urinary tract injury.

The presence of blood in the urine, pain in the lower back and suspicion of cancer are primary symptoms, which are indications for this study.

What is a review method?

Panoramic excretory urography is the simplest X-ray method research. This type of diagnosis can be put on a par with the usual x-ray kidney areas. A simple study allows you to study the state of the organs from the upper poles to the urethra.

Excretory urography is based on the study of the excretory functions of the kidneys, therefore, almost all images are taken at the time the organs secrete a contrast agent. This allows you to determine the rate of filling of the bladder and pelvis with fluid, as well as to identify the localization of neoplasms and calculi.

Excretory urography of the kidneys is also an indispensable method for examining other organs of the urinary system. This study allows you to get a detailed structure of each organ, because the pictures taken are more accurate when compared with conventional x-rays.

How is excretory urography of the kidneys performed?

When conducting an x-ray examination, a special contrast agent urographin is injected into the vein, which is displayed more clearly on the image of the vessels and surrounding tissues. The essence of the procedure called "excretory urography" is the administration of this substance intravenously and monitoring its penetration into the kidneys. While it enters the vessels and organs of the urinary system, the device captures every moment. The result is a whole series of images of the lower abdomen, which were taken at regular intervals.

Excretory urography allows you to determine even the slightest deviations using ultrasonic sensors by ultrasound. That is why, in the presence of any failures in the work of the kidneys, an examination should be carried out, which will allow timely identification of pathological processes and take measures to eliminate them.

Preparation for the examination

For determining pathological changes in the area of the organs of the urinary system, such a study as excretory urography is necessary. Preparation in this case is key point for a more accurate picture of the results. Before conducting the research procedure, you must pass special training, which includes a ban on eating foods that promote gas formation. In some cases, it is recommended to take activated charcoal 3 days before urography, and before the diagnosis itself, make a cleansing enema.

Excretory urography is an important research event, so before it is carried out, it is imperative to donate blood for analysis. The patient should warn the doctors about which drugs he uses in order to avoid getting inaccurate results.

Before the x-ray examination, the patient signs papers confirming the consent of the procedure. So, what is excretory urography of the kidneys? Preparation for this study includes a hypersensitivity test and administration of a contrast agent. In addition, tests for an allergic reaction to iodine are carried out.

Preparation for the procedure includes the following recommendations:

The last meal should take place no later than 3 hours before urography.
Take a laxative the night before.
Perform the procedure with an empty bladder.
Before the examination, remove all metal jewelry.
The doctor should warn the patient about possible appearance burning and redness of the skin after the contrast agent is injected.
Before the procedure, it is recommended to take sedatives and painkillers.

Excretory urography is not safe diagnostic procedure therefore, the patient must wear a special protective gown. Pictures of the organs of the urinary system are carried out in a special apparatus.

The whole procedure lasts no more than 45 minutes and depends on individual characteristics: the presence of stones in the kidney area, the localization of organs and their size. The accuracy of the results obtained depends on compliance with the preparatory rules for the diagnostic event.

Diagnosis of kidneys in children

For examining a child, it is important to approach correctly preparatory activities to get the most out of your research. Preparatory measures for children are practically no different from preparing for research for an adult.

To obtain the most accurate picture of the organs of the urinary system, give the child the evening before 2 g of sodium phosphate, diluted in 40 ml of 5% glucose. Important to consider right choice contrast agent (urotrast, triombrin, verografin or triiodtrast). For the correct calculation of the dosage, age, body weight, as well as functional state kidneys and liver of a child. During the procedure, it is necessary to ensure the immobility of the child, which, unfortunately, is not always possible. Only correctly performed urography allows you to accurately diagnose, and accordingly, prescribe effective treatment.

Contraindications

Excretory urography is not allowed in the following cases:

persons who have allergic reactions to injected contrast agents or iodine;
women during pregnancy and lactation;
patients who have increased bleeding;
persons suffering from renal insufficiency;
patients who have any degree of kidney damage.

Adverse reactions to urography

There is a small chance of developing adverse reactions during excretory urography of the kidneys. The following negative reactions on the diagnostic study:

the appearance of an iron taste in the mouth after the introduction of a contrast agent;
the occurrence of a reaction to contrast in the form of swelling of the lips and a mild transient rash (such symptoms may be an indication for the appointment of antihistamines);
during the procedure, pressure may drop sharply and breathing problems may occur;
in isolated cases, a sudden development of renal failure was recorded.

How much does a kidney exam cost?

The cost of organizing and conducting excretory urography is practically the same in different medical institutions. The price range varies within 300 rubles. The specific cost of the examination depends on its type, that is, survey urography is much cheaper than excretory urography.

In conclusion, I would like to clarify the fact that kidney urography, despite its informative value, is considered an unsafe procedure for all patients. That is why before the study, you should take an allergy test and consult with your doctor about the need to undergo this procedure.

More and more doctors are diagnosing various diseases kidneys.

To make a final diagnosis, patients undergo a number of laboratory and instrumental studies.

Doctors prescribe ultrasound procedure, magnetic resonance imaging and urography. These methods allow specialists not only to determine the external lesions of the kidneys, but also their internal changes.

Urography (cystography) is an X-ray study that studies structural changes kidneys and determining urolithiasis pathologies. Urography is carried out specialized specialists. Thanks to the results of urography, the doctor will be able to finally make a diagnosis and prescribe the appropriate treatment.

During the diagnosis, doctors inject a contrast agent into the kidney and it is highlighted on the X-ray. Thus, when the substance enters the urinary canals, it is easy to see, which allows you to fully study the structure of the genitourinary system.

Previously, this technique was used quite often, but since the procedure is not pleasant, now urography is being replaced by alternative diagnostics.

What does an overview view of urography show

Survey urography of the kidneys is carried out to determine:

size and weight;
border contours;
position and mobility;
forms;
general condition of organs abdominal cavity.

Thanks to this information, the doctor can accurately diagnose and prescribe the correct treatment.

The main advantage of this study is the fact that you can see all the organs of the abdominal cavity. Thus, the doctor determines or excludes other pathological processes.

In what cases is urography prescribed?

Urography has been developed in order to assess the functionality of the kidneys. Therefore, in almost all cases when there is a suspicion of a pathological process, doctors prescribe this diagnostic method.

With the help of a survey urography, doctors can determine:

the presence of a good or malignant neoplasm or tumor lesions;
structural changes in the renal tissue;
stones and small stones in the kidneys;
abnormal structure of the kidneys and urinary system;
possible complications of kidney injury;
nephrogenic hypertension (persistent arterial pressure caused by disease of the renal parenchyma), pyelonephritis ( inflammatory disease renal pelvis), glomerulonephritis (damage to the renal glomeruli), hydronephrosis (enlargement of the renal pelvis caused by impaired urine flow) and tuberculosis;
causes of blood in the urine.

Doctors may order a survey urogram if they suspect urinary tract infections. infectious processes caused by renal colic. Also, you can get an accurate picture of the kidney function after surgery.

Urography can 100% determine the type and severity of the lesion, stage pathological process. This allows doctors to choose an effective treatment.

In what cases is it forbidden to conduct a survey urography

Like others x-ray studies, urography is not performed for women during the gestation period. Experts do not recommend such a diagnosis for patients who have recently undergone contrast gastroscopy.

In such cases, the contrast agent makes it difficult to visualize the kidneys. If all the same there are indications for survey urography, then it is carried out a few days after the previous study.

During this time, the intestines are cleared of barium residues. It is strictly forbidden to conduct survey urography:

women during the period of bearing a baby;
patients with one kidney;
patients with chronic radiation sickness.

Preparation for survey urography

Before starting a diagnostic study, the patient must donate blood from a vein. Thus, doctors confirm or rule out kidney failure. Also, the patient passes a test in advance to determine the allergic reaction to the injecting substance.

The main condition for survey urography is special diet, which includes several basic rules:

two days before the diagnostic study, it is forbidden to eat fresh vegetables and fruits that have not been previously thermally processed;
it is strictly forbidden to consume cereals and beans, sweets and fresh pastries in two days;
per day, it is necessary to reduce the amount of fluid consumed to a minimum.

By following these simple rules can be achieved increased concentration urine, which in turn increase the contrast in the image.

Before the diagnosis, you can not eat enough. It is better to eat 10 hours before urography, and it is desirable if it is a light meal.

If a diagnostic study is scheduled for the morning, then before going to bed and in the morning it is advisable to do an enema. Thus cleared gastro- intestinal tract. Better not to have breakfast.

Preparation for urography depends on the type of diagnosis (survey, excretory or intravenous urography). Each urography has its own specific purpose, therefore, the preparation rules are different.

When conducting a survey urography, it is very important that the intestines are not filled with gases. Therefore, it is necessary to eat a few days before the study dietary products. Also, doctors prescribe activated charcoal or polyphelan.

You should not eat up before the procedure, but you should not be hungry, as gases can form in an empty stomach. Be sure to do two enemas - in the morning and before the study.

With the help of excretory urography, doctors determine the morphology of the kidneys. In this case, the presence of gases in the intestines can misinform the specialist.

The day before, doctors recommend drinking 30 gr. castor oil(about three teaspoons). This allows you to reduce gas formation in the intestines. Get rid of increased gas formation can be done with activated charcoal. To do this, you need to drink six tablets in the morning and six in the evening.

Before intravenous urography, it is enough to adhere to proper nutrition. Eliminate fatty, spicy and sweet. Thus, the gastrointestinal tract is cleansed and the images become clearer and more accurate.

How is kidney urography performed?

Conducted overview urography does not take much time and is easy to carry out. The patient takes a supine position, and a pillow is placed under the head. This is the maximum comfortable posture for a patient in which the main muscle groups do not strain. Before the diagnosis itself, the doctor talks with the patient, finding out the expressed discomfort and unpleasant sensation experienced by the patient in recent years.

If the doctor does not ask, then the patient himself must tell him about all the medicines that he has taken during the last month. The doctor directs the x-ray so that it is slightly lower than the xiphoid process.

The beam must pass strictly perpendicular to the body. at the moment when the machine takes a picture, the patient must not breathe. If you breathe during this period, then in the picture you can see how the doubling of the pelvicalyceal system or stones occurs.

Is survey urography harmful?

The human body may react negatively to the fact that a urographic study was carried out, namely:

burning in the veins into which the contrast agent was injected;
nausea;
flush of heat;
dizziness;
taste of iron in the mouth.

These conditions are considered normal and do not require special treatment. They will go away on their own in a few hours. To quickly remove the contrast agent from the body, doctors recommend drinking more, preferably if it is freshly squeezed juices, green tea or milk.

If the patient has no contraindications to this research technique, then adverse reactions respectively. It is possible that short-term x-ray exposure will occur.

Also, doctors may perform survey urography in young children, as this species research is absolutely safe. Only the dosage of the contrast agent is determined by the weight of the child and the functionality of the liver and kidneys. Since it is very difficult to force a child to lie in one position for a long time, the diagnosis is carried out at an accelerated pace. Not to happen allergic reaction children additionally take an antihistamine drug.

It is strictly forbidden to use this diagnostic method for children under one month old. Before the procedure, parents must mentally prepare the baby so that this is not a surprise for him. Then the diagnosis will be quick and painless.

How analyzes of survey urography are deciphered

The results of survey urography are deciphered by a specialist. Experts use two types of interpretation of the results. When conducting survey urography, healthy kidneys look like clear clouds. Wherein left kidney slightly lower right.

The organs of the abdominal cavity are deployed towards the spine. The ureters and bladder were not found on the x-ray. If the patient has urolithiasis disease, then the stones are clearly defined. "Humpbacked" kidney is considered the norm. In 42% of patients, one kidney is not visible.

Otherwise, the contrast agent should visualize the kidneys well. The bladder and ducts should be in a prominent place. At healthy kidney homogeneous structure.

Doctors need to determine if the contrast agent is leaking out of the kidneys. If it comes out, then this indicates a rupture of the ureters.

If the patient has diseased kidneys, then the doctor will immediately determine this.