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Why
would I need the Intravenous Urogram (IVU)?
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There
is a relatively long list of reasons, but the commonest condition would be
the suspected presence of stones in the urinary tract. Your doctor would
like to know how the urine is draining from the kidney to the bladder and
how the stones have affected your urinary system.
This
may be used complementing the ultrasound of the kidneys and vice versa. It
is also used in the investigation of other suspected causes of urine
“obstruction” or blood in the urine.
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What are
the special preparations?
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Fasting
instructions
If
the procedure is in the afternoon, you can take a light breakfast. Up
until 4-6 hours of the procedure, you can take a small cup of clear fluids
per hour.( e.g. Water, fruit juice, black tea or black coffee). It is
preferable that nothing be taken for at least 4 hours prior to the
procedure. Water is allowed in diabetics, myeloma patients, renal failure
and for other conditions where dehydration is contraindicated (should not
be allowed).
Medication
instructions
None
(other than, see below) are required unless you have asthma or known
allergies. In which case, the indication for the examination is reviewed,
since you can develop a reaction to the contrast media used. If your
doctor feels the benefits of this procedure will outweigh the risks, then,
you may be prescribed prednisolone (a type of steroid medication) tablets
prior to the examination. This would be 40 mg 12 hours and then, 40mg 2
hours prior to the procedure. Sometimes in an urgent examination, you may
be “unprepared” and have a known allergy; you may be given an
injection of Hydrocortisone 100 mg (another type of steroid) just prior to
the examination.
Bowel
preparation
Low residue vegetable-free diet for 1 day prior to the
examination. Water to be taken freely during this period before fasting
begins (see above). You may be given laxatives such as 2 tablets of
Dulcolax at 9 pm the night before the examination.
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What
actually happens during an IVU examination?
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You
will change into a gown for this examination and asked to empty your
bladder (pass urine). You will lie on the special table and
radiographs of your abdomen will be done at certain intervals.
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Contrast
will be given (via a needle through a vein in your forearm/arm) after
a preliminary radiograph.
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In
the early stages, some compression (only for a few minutes) may be
applied to the lower abdomen by means of pads and a belt or there may
only be a head down tilt of the table.
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In
normal flow of urine from the kidney to the bladder, this procedure
will take at least 30 minutes to complete. You will be asked to pass
urine before the final film is taken. However, depending on your
condition, there may be more films and delayed views as well.
This examination is always
tailored to your urinary system function and may involve modifications and
even additional drugs (e.g. diuretic) to further evaluate your condition.
It may also take several hours to complete. At the end of the examination,
the radiologist should be able to answer the questions that prompted your
doctor to send you for an IVU!
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Will
there be complications?
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The
only significant potential complications usually arise from the
contrast media.
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These
would be minor (generalised warmth, to rashes) to moderate, asthma and
difficulty breathing, a drop in the blood pressure (usually transient)
or rarely, severe and life threatening (anaphylaxis).
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Rarely,
there may be severe discomfort/pain when compression is applied, but
usually, the compression will be released the moment you notify the
radiographer in charge of your examination.
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Are
there any special instructions after an IVU?
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There
is usually no special instructions post IVU. You may eat and drink unless
your referring doctor has another examination or procedure for you after
the IVU examination
.
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Copyright © 2001-2010 College of Radiology, Academy of Medicine of Malaysia
All Rights Reserved
Terms
of Use Last
Updated:
Thursday, 21 August, 2003
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