Pyelogram

A pyelogram is a type of X-ray used to detect cancer in certain organs, including the bladder, kidneys and ureters. In males, a pyelogram also takes images of the prostate, which is located below the bladder. A pyelogram is one of several imaging tests that help identify cancerous tumors.

Types of pyelograms

An intravenous pyelogram (IVP)—also called an intravenous urogram (IVU)—is done by injecting a special dye called contrast material into one of your veins. Health providers take X-rays as the contrast material moves through the urinary tract organs. Those X-rays may help detect blockages that may be caused by cancer.

Besides cancer, a pyelogram also detects kidney stones, kidney cysts, an enlarged prostate and other problems of the urinary tract.

Another type of pyelogram—called a retrograde pyelogram—involves inserting a thin tube through your urethra (which moves urine from the bladder to the opening for urination). From there, the tube goes into the bladder or a ureter (tubes that move urine from the kidneys to the bladder). Your care team then injects dye to help show the lining of the urinary tract organs on X-rays to look for tumors.

The intravenous pyelogram is done more frequently than a retrograde pyelogram, which is considered an alternative if you cannot have an intravenous pyelogram.

Overall, computed tomography (CT) scans are used more often nowadays than pyelograms. A CT scan is another type of X-ray that rotates around you and takes pictures. These pictures provide more detail than a pyelogram.

How to prepare for a pyelogram

• Let your care team know in advance if you’re pregnant, allergic to contrast material or have kidney problems.
• Find out what you may eat or drink, if anything, before having a pyelogram. You may have to fast starting at midnight on your exam day.
• Your doctor may ask you to take a laxative the evening before the pyelogram. This helps your kidneys to be seen more clearly.
• When you show up for your test, you’ll be asked to remove clothing and jewelry and wear a hospital gown.

What to expect during a pyelogram

A pyelogram is typically performed at a provider’s outpatient office or in a hospital’s radiology department. Be prepared to empty your bladder in advance of the pyelogram.

While lying face-up on an X-ray table, an iodine-based contrast material is injected into a vein in your arm. It’s normal to feel a sensation of heat when the dye is injected or to experience a metallic taste in your mouth. This should go away rapidly.

Next, the X-ray technician turns on the X-ray machine and takes several pictures of your urinary tract. It’s important to lie still. You may have a belt over your abdomen area that helps the contrast material stay in the urinary tract area. The belt may feel a little tight. After a few minutes, the technician may ask you to urinate again.

After this, the technician takes additional images of your urinary tract to see how much contrast material is left.

When finished, drink water to help remove the contrast material from your body.

Benefits and risks of a pyelogram

The benefit of a pyelogram is to detect blockages from cancer or other causes, such as kidney stones. Once your doctor knows what’s causing a problem in your kidneys or elsewhere in the urinary tract, the next step is to recommend the appropriate treatments.

A pyelogram has a few associated risks:

• A possible allergic reaction to the contrast material. Those who have such a reaction usually have only mild itching or a rash, but sometimes there are more serious reactions. Inform your care team in advance if you’re aware of an allergy to contrast material.
• A low dose of radiation that could hurt an unborn baby. Let your health provider know if you’re pregnant.
• A metallic taste in the mouth when the dye moves throughout the body. However, this should go away after a couple of minutes and is not harmful.

If you cannot have an intravenous pyelogram because of the associated risks, your care team may instead perform a retrograde pyelogram, a magnetic resonance imaging (MRI) scan or an ultrasound.

Reviewing the results of a pyelogram

A radiologist reviews the pyelogram results and shares them with your doctor. Abnormal results may indicate a tumor or cyst in the urinary tract, kidney stones, damage or scarring, or an enlarged prostate in males.

Depending on the results, you may need to undergo other tests or treatments. Make sure to ask your care team any questions that you have about the results.