Retrograde pyelography
Published by Bupa's health information team, January 2009.
This factsheet is for people who are planning to have retrograde pyelography, or who would like information about it.
Retrograde pyelography is an X-ray test used to examine the urinary system (kidneys, ureters and bladder).
Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your doctor's advice.
- About retrograde pyelography
- What are the alternatives?
- Preparing for your procedure
- About the procedure
- What to expect afterwards
- Recovering from retrograde pyelography
- What are the risks?
- Further information
- Questions and answers
- Related topics
- Sources
About retrograde pyelography
In retrograde pyelography, a contrast fluid (special contrast dye that shows up in X-rays) is injected into the tubes that carry urine from your kidneys to the bladder (ureters). The fluid travels up the tubes into the kidneys. X-ray pictures are taken during the procedure.
Retrograde pyelography can help identify obstructions such as stones, tumours, blood clots or narrowing in the kidneys or ureters.
The position of the kidneys and surrounding structures
What are the alternatives?
Your doctor may suggest alternative imaging tests, such as intravenous urogram, plain X-rays of the urinary system, CT (computed tomography) scan or renal ultrasound.
Retrograde pyelography is only done if other tests have been inconclusive or if you have poor kidney function which makes it difficult to do other tests.
Preparing for your procedure
Retrograde pyelography is routinely done as a day case. This means you have the test and go home the same day.
The procedure is usually done under general anaesthesia. This means you will be asleep during the test. Sometimes, it's done under regional anaesthesia. This completely blocks feeling from the waist down and you stay awake. A sedative may be given with regional anaesthesia to help you relax. Your doctor will advise which type of anaesthesia is most suitable for you.
If you are having general anaesthesia, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
At the hospital your nurse may check your heart rate and blood pressure, and test your urine.
The test involves X-rays. Usually a radiographer (a health professional trained to perform imaging procedures) operates the X-ray machine and produce images on film or in digital format.
You must tell your doctor or radiographer about any medicines you are taking and if you have any allergies, glaucoma or heart disease. If you are a woman of childbearing age, you must tell your doctor or radiographer if you could be pregnant. X-rays are safe for adults, but may harm your developing baby. If you're pregnant, your doctor will discuss alternatives to the procedure.
Your doctor will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
About the procedure
Retrograde pyelography usually takes 10 to 20 minutes.
Your doctor will carefully pass a rigid telescope (called a cystoscope) through the urethra (the tube that carries urine from the bladder and out of your body) into the bladder. A camera attached to the end of the tube allows your doctor to examine the inside of your bladder.
Next, your doctor will insert a thin tube (catheter) through the cystoscope into the opening of the ureters and inject the contrast fluid. An X-ray machine positioned above your pelvis will take pictures as the fluid flows through the ureters into the kidneys. Afterwards, the contrast fluid is drained away and the catheter is removed.
You may be given intravenous antibiotics to reduce your risk of urinary infection.
What to expect afterwards
You will need to rest until the effects of the anaesthetic have passed.
You will be able to go home when you feel ready. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
Results
Your results may be discussed with you immediately after the test or at a later date. Alternatively, a report may be sent to the doctor who recommended your test.
Recovering from retrograde pyelography
Drink plenty of clear fluids over 48 hours to help flush your bladder and reduce your risk of infection.
Contact your GP if you develop any of the following symptoms, as you may have developed an infection:
- severe pain or pain that lasts for more than 48 hours
- high temperature
- burning sensation on passing urine or if your urine starts to smell
- heavily blood-stained urine
What are the risks?
Retrograde pyelography is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure. You will be exposed to some X-ray radiation. The level of exposure is about the same as the background radiation that you would receive naturally from the environment over 12 to 14 months. X-rays can harm a developing baby in pregnancy. If you are, or think you may be pregnant, tell your doctor before your appointment.
Side-effects
These are the unwanted but mostly temporary effects of a successful procedure.
Side-effects of retrograde pyelography include:
- feeling some discomfort when passing urine
- feeling mild stinging when passing urine
- some blood in the urine for 24 hours
Complications
This is when problems occur during or after the procedure. Most people are not affected. Complications of retrograde pyelography are uncommon but can include:
- urinary tract or bladder infection (cystitis) - you may need antibiotics to treat this
- damage to the urethra or bladder - this may require treatment with medicines or surgery
- urinary retention - you may need a temporary catheter to help drain urine from your bladder
- allergic reaction to contrast fluid - medicines are available to treat this
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your doctor to explain how these risks apply to you.
Further information
- Bladder and Bowel Foundation
01536 533255
www.bladderandbowelfoundation.org
Retrograde pyelography Q&As
See our answers to common questions about retrograde pyelography, including:
Related topics
Sources
- Retrograde pyelography. American Urological Association. www.urologyhealth.org, accessed 22 August 2008
- X-rays: how safe are they? National Radiological Protection Board. www.hpa.org.uk, accessed 22 August 2008
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: January 2009
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