Urography

The urography is a diagnostic test using contrast material for evaluation of various disorders and conditions affecting the urinary system : housed kidney stones or bladder, blood in the urine …

Thanks to urography, both the morpholphy and the function of the urinary system can be analyzed. This test provides a detailed picture of the kidneys and urinary tract. And, in addition, it offers very precise information on the purification of the kidneys.

What is urography?

Urography is a diagnostic test based on X-rays for the study of the urinary system as a whole: kidneys, ureters, bladder and urethra. Generally, the test consists of the injection of a contrast medium intravenously, which diffuses throughout the body through the bloodstream and is filtered by the kidneys to pass into the urine. In this way, X-rays can show the urinary tract “drawn” on the image.

Urography is contraindicated in pregnant or lactating women . In the case of pregnancy, exposure to X-rays, as well as radiological contrast, can harm the fetus. In relation to breastfeeding, it is not a direct contraindication, although it is recommended to avoid the test until the end of this period.

It is also not indicated in those patients who have a serious heart disease, as well as an allergy to iodine .

History and evolution

The origin of urography is located in Germany at the beginning of the 1920s thanks to the important advances made in iodinated radiological contrasts. Thus, during its first years of life urography was a widely used test, used for the diagnosis of practically any disorder related to the urinary system, including bladder cancer, for example.

To date, urography has sometimes been displaced by other less invasive diagnostic tests such as ultrasound or computed tomography. However, it continues to be very important in cases of renal colic or studying a certain surgery of the urinary system.

Why is urography done?

In relation to the reasons that lead the specialist doctor to request a urography, they can be grouped into two broad categories. On the one hand, purely diagnostic reasons to confirm a certain disorder of the urinary system. And, on the other hand, planning an intervention since urography allows us to observe the urinary tract with great precision. Here are some of the most common conditions for which this medical test is performed.

Renal colic

Renal colic occurs when dissolved salts in the urine form stones that obstruct the urinary tract and, therefore, the passage of urine. It is characterized by producing intense pain to the sufferer, generally located in the lower back and on the side.

In a high percentage of cases, the pain is accompanied by other symptoms, such as discomfort when urinating, nausea and vomiting, or even fever in the most severe cases.

Urinary tract malformation

Urography allows a comprehensive and detailed visualization of the urinary tract, being able to observe its shape and size precisely . Thus, this medical test can detect a lack of development of any of the parts that make up the urinary tract.

Loss of blood

The presence in the urine is a condition that occurs relatively frequently in the adult population. Although in the vast majority of cases its origin is not in a serious disease, it is important to find the cause.

Thus, using iodinated contrast, it is possible to observe in which area of ​​the urinary tract the bleeding is occurring . In this way, it can be diagnosed and treated before the blood leaks through the kidneys.

Urethral stricture

Urethral stricture is the narrowing of the ureters, which can cause kidney stones to lodge at a certain point in the urinary tract , or even prevent the passage of urine. In general, it is a congenital disorder, although sometimes it can also be caused by an infection or intervention.

Tumors

Urography can detect both malignant and benign tumors . This is because its blood circulation presents a series of irregularities, thus being different from that of the kidney.

Plan an intervention

As we have pointed out, urography is sometimes very useful in the planning of interventions since it allows us to know in detail the shape and size of the urinary system .

How is a urogram done?

Urography is a diagnostic test that is performed on an outpatient basis, so hospital admission is not necessary. However, after the test the patient must remain for a few hours under observation.

Of course, prior to performing the test, it is important to inform the doctor of all the medications that are taken since some may interfere with the results. In certain cases the doctor recommends the administration of laxatives so that the colon is completely clean during the urography, so that the kidneys can be seen without difficulty.

And finally, it is advisable to fast for eight hours before the test .

Preparation

Prior to the urography, a series of basic tests are performed.

• Electrocardiogram: The electrocardiogram is a diagnostic test used to assess heart rhythm and function. It is a painless test, in which electrical activity is collected by electrodes that are attached to the skin on the front of the chest, as well as on the arms and legs.
• Blood tests : one of the most used medical tests. It consists of the extraction of a small blood sample to evaluate different elements: red blood cells, leukocytes … It allows to assess the general condition of the patient.

Process

Once the patient goes to the hospital, he must change clothes and put on a dressing gown. Next, the doctor proceeds to measure the blood pressure , placing a cuff on the arm.

The next step is the placement of a venous line in the other arm and the injection of the iodinated contrast . At the time of injection, it is normal to feel a great sensation of heat in the arm , as well as hot flashes and a metallic taste in the mouth. It is a frequent reaction, and it does not last more than a few seconds.

During the X-rays, the patient must remain completely immobile ; otherwise, they will be blurred, requiring a retest. The test lasts several minutes, until all of the contrast has filtered through the kidneys, and has been expelled through the urine.

Once the urography is finished, the patient must remain under observation for a few hours . During this period of time you should drink a large amount of liquid to cleanse the body and thus avoid acute kidney damage.

Before final discharge, the patient must urinate so that the doctor can check if the appearance and color of the urine are normal.

Complications of urography

Urography, like any other medical test, has a number of complications that are interesting to know about. It is worth noting that these are very rare.

• On certain occasions, iodinated contrast gives rise to a feeling of discomfort, characterized by nausea and vomiting. Some patients have a headache, and even loss of consciousness.
• An allergic reaction to the radiographic contrast medium can also occur .
• Another complication of urography has to do with alterations in the thyroid gland . It is a butterfly-shaped gland located in the neck, which is responsible for the production of hormones and controlling the rhythm of a wide range of activities and functions of the body.
• And finally, in a minimal percentage of cases there is acute renal failure . It occurs when the kidneys are unable to filter waste products from the bloodstream. Thus, high levels of residues can accumulate in the body, which requires urgent medical assistance.

Results

Once the urography is performed, the patient must return after a few days to collect the results of the same.

The results of this diagnostic test are obtained in a series of stages. First, an initial filtering to study the kidneys . Second, the exhaustive analysis of the kidneys, as well as the ureters. Next, the evaluation of the passage of contrast through the ureters. And, in fourth and last place, the retention of urine in the bladder.

Conclusion

Urography is a widely used diagnostic test in today’s medical field. It allows a detailed and precise study of the entire urinary system , so it is used for the diagnosis of certain diseases, as well as for planning surgeries and interventions.