Intravenous Pyelogram (IVP)

What is an intravenous pyelogram (IVP)?

An intravenous pyelogram (IVP) uses x-rays to take pictures of the organs of your urinary tract. These are the organs that make urine (pee) and remove it from your body. They include your:

• Kidneys, two organs located below the rib cage, one on each side of your spine. They filter your blood to remove waste and extra water in urine (pee).
• Bladder, a hollow organ in your pelvis (the area below your belly). It stores urine.
• Ureters, thin tubes that carry urine from your kidneys to your bladder.

IVP uses contrast dye to make these organs show up well on x-ray images. In males, x-rays from an IVP can also show the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder and makes the fluid part of semen.

During an IVP, contrast dye is injected into a vein using an intravenous (IV) line. The dye travels through your bloodstream to your kidneys, which filter it out. The dye collects in the organs of your urinary tract and makes them look bright white on the x-rays. This allows your health care provider to see blockages or other problems that affect your urinary organs.

IVP isn't commonly used anymore. Instead, providers usually order CT (computerized tomography) scans to see the urinary tract. CT scans can provide more information than x-rays from an IVP. But IVP may be useful in certain situations.

Your provider can explain the pros and cons of having an IVP or a CT scan. In certain cases, MRI scans (magnetic resonance imaging) or ultrasound may also be options for looking at the urinary tract.

Other names: excretory urography, intravenous urography

What is it used for?

An IVP may be used to help find the cause of symptoms that may involve the urinary tract or prostate. It can be used to help diagnose disorders such as:

• Kidney stones
• Stones in the bladder or ureters
• Kidney cysts
• Enlarged prostate (BPH)
• Tumors in the kidneys, bladder, or ureters (cancerous and not cancerous)
• Birth defects that affect the structure of the urinary tract
• Scarring from a urinary tract infection (UTI)

IVP usually isn't used during pregnancy or for infants and children.

Why do I need an IVP?

You may need an IVP if you have symptoms of a urinary tract disorder. These may include:

• Pain in your side or back
• Sharp pains in your abdomen (belly), side, groin or back
• Blood in your urine
• Cloudy or bad-smelling urine
• Pain when urinating (peeing)
• Needing to urinate frequently, or not being able to urinate
• Nausea and vomiting
• Swelling in your feet or legs
• Fever and chills

You may also need an IVP if you have had many urinary tract infections or have had an injury that may have damaged your urinary organs.

What happens during an IVP?

An IVP may be done in your provider's office or a hospital. The test is often done by a radiology technician (a health care professional who is trained to do x-ray exams). The procedure takes about an hour and generally includes these steps:

• You'll usually remove your clothing and put on a gown.
• You'll lie down on your back on an x-ray table. The technician will take an x-ray to make sure the machine is set right for you.
• The technician will insert an IV into a vein in your arm or hand and inject the contrast dye.
• Several x-rays will be taken to see how your kidneys filter the dye. You may be asked to move into different positions.
• The technician may wrap a special belt tightly around your belly. This helps keep the contrast dye in your kidneys. After the belt is removed, more x-rays will be taken to show the dye passing from your kidneys through your ureters and into your bladder.
• Before the IVP is finished, you'll be asked to use the bathroom or a bedpan to urinate. Then the last x-rays will be taken to see if any urine remains in your bladder. This shows how well your bladder works to empty urine.

After the test, drinking plenty of fluids will help flush the contrast dye out of your body.

Will I need to do anything to prepare for the test?

Your provider will give you instructions for how to prepare for an IVP. You will probably need to fast (not eat or drink) after midnight on the night before your test. You may also be asked to take a mild laxative the evening before the IVP. A laxative is medicine that helps you empty your bowels (poop).

Are there any risks to the test?

There's a small chance you could have an allergic reaction to the contrast dye. Reactions can often be managed with medicine. Serious reactions are rare. But certain conditions may increase the chance of problems, such as having other allergies, congestive heart failure, or diabetes. If you have any of these conditions, tell your provider. You may be able to take medicine before the IVP to reduce the chance of reacting to the dye.

When the contrast dye is injected, you may feel itchy, warm, or queasy. Some people have a metallic taste in their mouths. These feelings are harmless and usually go away quickly.

Tell your provider if you are pregnant or think you may be pregnant. An IVP delivers a low dose of radiation. The dose is safe for most people, but it can be harmful to an unborn baby.

What do the results mean?

Your IVP images will be studied by a diagnostic radiologist. This is a doctor who specializes in examining x-rays, MRIs, and other medical images to diagnose medical conditions. The radiologist will send a report with your IVP results to your provider. The report will explain exactly what the x-rays showed.

In general:

• Normal results mean that:
  • The organs of your urinary tract looked normal, and no blockages were seen.
  • Your kidneys, ureters, and bladder worked normally to filter the dye and pass it out of your body.
  • In males, the prostate was the right size, and no problems were seen.
• Abnormal results mean that something irregular was found on your IVP images. Ask your provider to explain your report and diagnosis. Examples of abnormal results include:
  • One or more of urinary tract organs did not appear to be the right size or shape, or it was not in the usual place.
  • A tumor, stone, cyst, injury, scar, or some other abnormal area of tissue was found and may be blocking the flow of urine.
  • Your urinary tract did not filter the dye and/or pass it out of your body as quickly or completely as it should.
  • In males, the prostate was larger than normal.

Learn more about laboratory tests, reference ranges, and understanding results.