An antegrade pyelogram is a type of X-ray used to diagnose an obstruction of the upper urinary tract. During the procedure, a contrast dye is injected into a portion of the ureter (narrow tube that carries urine from the kidney to the bladder) closest to the kidneys called the renal pelvis. The flow of the contrast dye can then be observed with X-ray images as it moves from the kidneys into the ureters and urinary bladder.
Fluoroscopy (a type of X-ray "movie") or ultrasound (high frequency sound waves) may be used during the procedure to locate the kidneys and ureters.
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body structures onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film).
Other related procedures that may be used to diagnose problems of the upper urinary tract include kidney, ureters, and bladder (KUB) X-ray, computed tomography (CT scan) of the kidneys, renal ultrasound, renal angiogram, intravenous pyelogram (IVP), retrograde pyelogram, and renal venogram . Please see these procedures for additional information.
The body takes nutrients from food and converts them to energy. After the body has taken the food that it needs, waste products are left behind in the bowel and in the blood.
The urinary system keeps chemicals, such as potassium and sodium, and water in balance, and removes a type of waste, called urea, from the blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys.
Other important functions of the kidneys include blood pressure regulation, and the production of erythropoietin, which controls red blood cell production in the bone marrow.
The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.
An antegrade pyelogram may be used to visualize the ureters when other procedures, such as intravenous pyelogram and retrograde pyelogram, have not provided enough definitive information.
The antegrade pyelogram may be used to detect an obstruction of the urinary tract due to a stricture (narrowing), a kidney stone, a blood clot, or a tumor. In the presence of an obstruction, the injected contrast dye is unable to move properly through the kidney and this is detected on X-ray images.
An antegrade pyelogram may also be used to assess the kidneys or ureters prior to or after surgical treatment. If a blockage is found, a nephrostomy tube may be inserted during the procedure to divert the flow of urine past the obstruction.
There may be other reasons for your physician to recommend an antegrade pyelogram.
You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your physician. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your physician. Radiation exposure during pregnancy may lead to birth defects.
If contrast dye is used, there is a risk for allergic reaction to the dye. Patients who are allergic to or sensitive to medications, contrast dye, or iodine should notify their physician.
Patients with kidney failure or other kidney problems should notify their physician. In some cases, the contrast dye can cause kidney failure, especially if the person is taking Glucophage (a diabetic medication).
Possible complications of antegrade pyelogram include, but are not limited to, the following:
An antegrade pyelogram may be contraindicated for patients with blood clotting disorders.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
An antegrade pyelogram may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.
Generally, an antegrade pyelogram follows this process:
Your recovery process will vary depending upon the type of procedure performed and your physician’s practices. After the procedure, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home.
Your urine output will be monitored closely for volume and signs of blood. It may be red from even a small amount of blood. This is considered normal and does not necessarily indicate a problem. You may be instructed to continue monitoring your urine output for a day or so once you are at home.
You may experience pain when you urinate. Take a pain reliever for soreness as recommended by your physician. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Notify your physician to report any of the following:
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
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