Intravenous Pyelogram (IVP)

What is an intravenous pyelogram (IVP)?

An intravenous pyelogram (IVP) uses x-rays and contrast dye to get clear 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 from 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.

The contrast dye is injected into a vein using an intravenous (IV) line. It then 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. In certain cases, MRI scans (magnetic resonance imaging) or ultrasound may also be options for looking at the urinary tract.

Your provider can explain the pros and cons of having an IVP or a CT scan.

Other names: excretory urography, intravenous urography, excretory urogram

What is it used for?

When an IVP is used, it can help find:

• Problems with the structures in the urinary tract, such as an organ that is larger than usual or not in the usual place
• Kidney stones
• Blockages in the urinary tract, such as stones in the bladder or ureters

A provider may also use the test to help find:

• Kidney cysts
• Cancerous and not cancerous tumors in the kidneys, bladder, or ureters
• Birth defects that affect the structure of the urinary tract, such as medullary sponge kidneys (a condition that affects the tiny tubes inside the kidneys)
• Scarring from a urinary tract infection (UTI)

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. An IVP can check for an enlarged prostate (BPH) or any other prostate disorders.

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:

• 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 during it you will:

• Usually remove your clothing and put on a gown.
• 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.
• Have an IV inserted into a vein in your arm or hand. This is how the technician will inject the contrast dye.
• Have several x-rays taken to see how your kidneys filter the dye. You may be asked to move into different positions.
• Have a special belt tightly wrapped 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.
• Be asked to use the bathroom or a bedpan to urinate before the IVP is finished. 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 having a reaction, such as:

• Other allergies
• Congestive heart failure
• 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 nauseated. Some people have a metallic taste in their mouths. These effects 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 a fetus.

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

In general, abnormal results mean that:

• One or more of your 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 unusual area of tissue was found and may be blocking the flow of urine
• Your urinary tract did not filter the dye or pass it out of your body as quickly or completely as it should
• In males, the prostate was larger than normal

Abnormal results may mean many different things. They may also be inaccurate if you have:

• Stool or gas in your colon
• Poor blood flow to your kidneys
• Barium in your intestines, usually from a recent barium swallow

Ask your provider to explain your report and any diagnosis. If you do have abnormal results, your provider may order other tests, such as CT scans and MRIs, to get a better understanding of the health of your urinary tract.

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