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What is a Retrograde Pyelogram?

By P.S. Jones
Updated Mar 03, 2024
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A retrograde pyelogram is medical procedure, in which the doctor injects a radioactive dye into the ureter before X-raying the patient in an effort to get a clearer view of the ureter and the kidneys. The dye makes it easier for the physician to diagnose any abnormalities. The dye then travels from the bladder to the kidney in the opposite direction of the usual flow of fluid, which is how the procedure gets its name. As the technology behind ultrasound, and other diagnostics improve, retrograde pyelograms are becoming less common.

Physicians use a retrograde pyelogram to determine abnormal blockages, or fluid flow in the bladder and kidneys. Obstructions like kidney stones, tumors and blood clots can all be screened using retrograde pyelograms. The narrowing of the kidney or urethra tubes can also be detected through a retrograde pyelogram. Patients who receive this procedure may be experiencing pain in their lower regions, or having trouble urinating.

During the retrograde pyelogram, the patient will first be asked to remove any clothing or jewelry that may interfere with the procedure. Some patients may have an intravenous line (IV) inserted in their arm or hand to administer a mild sedative before the procedure. Next, the patient will be asked to lie face up on the X-ray table with his or her legs in stirrups.

Then an endoscope will be inserted through the urethral opening, and then into the bladder. The endoscope can be a rigid or flexible tube that may have a light attached to it for increased visibility. This will be followed by a catheter, through which the dye will be injected. A series of x rays will be taken during timed intervals to track the dye as it travels through the bladder and the kidneys.

Recovery after the procedure will depend on the general health of the patient. In most cases, once the patient is alert, and their blood pressure, pulse and breathing are all stable, he or she will be released to go home, as long as there are no other medical issues at hand. The patient’s urine will be monitored closely for signs of blood or irregular volume over the next few days. There may be some blood in the urine, or pain while urinating, but this is not necessarily abnormal or indicative of a problem. The physician should be notified immediately if the patient experiences fever or chills, increased pain around the urinary opening, or increased difficulty urinating.

Having a retrograde pyelogram carries minimal risk. The amount of radiation in the dye used during the procedure is very low, but patients who may be pregnant may be advised to avoid this procedure. The dye used may also cause allergic reactions in a small percentage of patients. Anyone with an allergy or sensitivity to any types of dyes, iodine, or shellfish should be careful. Patients with pregnancies or allergies should discuss these concerns with their physician before having a retrograde pyelogram done.

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