What is Retrograde Pyelogram? Let's talk about it simply!

You may have been experiencing some discomfort, pain, or other problem with your urinary system and have gone to see a doctor. Then, the doctor may have said that he needs to check the condition of your internal organs, such as your kidneys and urethra. Today, we are going to talk about a special test that is performed at such times.

Simply put, what is Retrograde Pyelogram?

Imagine you want to get a clear picture of the inside of your urinary system, which is your kidneys and the tubes that carry urine from them to your bladder (ureters). This isn't visible on an X-ray. So, in this test, a special liquid called a 'dye' (contrast agent) is injected into your urethra, and then a series of X-ray pictures are taken. The dye makes the shape of your urinary system and the inside of it show up very clearly on the X-ray in white.

This is called "retrograde," because normally urine travels down from the kidneys. But in this test, we send the dye from the bottom up, in the opposite direction of the urine. That's what the name means. A "pyelogram" is a picture taken of the main part of your kidney where urine collects (the renal pelvis).

How is this different from an Intravenous Pyelogram (IVP)?

You may have heard of another test similar to this, called an Intravenous Pyelogram (IVP). Both use a dye to take pictures of the urinary system. The main difference is how the dye is injected into the body.

• Intravenous Pyelogram (IVP): Here, dye is injected into a vein in your arm . The dye then travels through your bloodstream, filters through your kidneys, and enters your urinary system before being X-rayed.
• Retrograde Pyelogram: Here, the dye is inserted directly into the ureter . A special instrument is used for this.

Now you may be wondering why there are two methods. The main reason is that some people are allergic to the dyes used in X-rays. In IVP, the dye is added to the blood, so there is a higher chance of an allergy. However, in Retrograde Pyelogram, the dye is injected directly into the urethra, so it is unlikely to be added to the blood. Therefore , even someone with an allergy to dyes can safely have this test .

However, currently, a CT scan (Computed Tomography) is more often performed than either of these tests. It can provide clearer images.

For what reasons would a doctor ask you to do this test?

Your doctor may usually recommend this test in the following cases:

• If you suspect that your ureter has been damaged .
• If you suspect that there is a blockage or narrowing somewhere in the urethra.
• If you want to check for stones or tumors in the kidneys, ureters, or bladder.
• If you need to insert a stent , a small tube that keeps the tube open, into a urethra, you need a clear image.
• If you want to take a good look at the inside of the urinary system before undergoing another treatment, such as a ureteroscopy .

How do you prepare before the test?

This is a test that is usually done in a hospital. You have no reason to be afraid of it. But there are a few things you should be aware of before you do it.

1. Talk to your doctor: You should definitely tell your doctor about any other medical conditions you have, any medications you take (especially blood thinners ), any allergies you have, and if you are pregnant.

2. Anesthesia: This test is done under general anesthesia. This means that you will not feel any pain. In most cases, you will be put completely asleep (general anesthesia). Therefore, you will not be able to drive a vehicle on your own after the test. Make sure to bring someone to take you home .

3. Food and Drink: You will be advised not to eat or drink anything the night before the test or until the doctor tells you to. Follow those instructions exactly.

4. Clothing and Jewelry: On the day of your visit to the hospital, do not wear expensive jewelry . Wear comfortable, loose clothing.

What happens during the test?

Okay, now let's take a step-by-step look at what happens during the test. Knowing this will help you ease your fear.

• First, the hospital will give you a special gown to wear.
• Then a nurse will insert a small cannula (IV line) into a vein in your arm. Through it, they will give you saline and any necessary medications to help you relax.
• Next, the anesthesiologist comes and puts you under anesthesia. After that, you will fall asleep soundly. You won't feel anything .
• After you are asleep, the doctor will insert a very thin tube called a cystoscope , which has a small camera at the end, into your urethra and pass it through your bladder to the opening of your ureter.
• Then, another thin tube is passed through that device into the urethra, and the special dye is slowly inserted through it.
• Once the dye is properly inserted, the X-ray machine takes a series of pictures.
• If there is any other treatment that needs to be done at the same time as this test, such as removing a stone, the doctor will do that right away. Otherwise, he will remove all the equipment and begin to bring you back to consciousness.

Things to look out for after the test

After the test is over, you will be taken to a separate room (recovery unit) for observation. The medical staff will take care of you until you regain full consciousness and your blood pressure and breathing return to normal.

• They will pay attention to whether there is any blood in your urine and how much urine you are passing.
• Even after you go home, you will be given clear instructions about the medications you need to take, what you should and shouldn't eat, and when you should call the doctor again.
• Once your condition is confirmed to be good, you can go home with the person who came to pick you up.

What are the advantages of this test?

Is there any risk?

As with any medical test, there are some very small risks involved, but it is considered a very safe test .

• Possible complications related to anesthesia (these are very rare).
• There is a small chance of developing Urinary Tract Infections (UTI).
• There is a very small risk of damage to the bladder or urethra during insertion of the instruments.

How long does it take to recover and when should you see a doctor?

You can usually return to work or normal activities within a few days. You can eat normally. It is very important to drink plenty of water .

If you experience the following symptoms, you should call your doctor immediately .

Retrograde Pyelogram, Medical Tests, Urinary System, Kidney Disease, Urinary Stones, X-ray, Cystoscopy, Ureter, Urinary Tract Infection