What is a urography?
During a urography, the doctor uses an X-ray examination to visualize the urinary tract. These include
- renal pelvis
- Ureter (ureter)
- Urinary bladder
- Urethra (urethra)
The kidneys and ureters are referred to as the upper urinary tract, the bladder and urethra as the lower urinary tract. These organs cannot be seen on a normal X-ray. To do this, the doctor needs a so-called contrast agent, which he administers to the patient either directly via the urinary tract or via a vein.
If only the kidneys are examined during the examination, this is known as pyelography.
Retrograde urography
In retrograde urography, the contrast agent is introduced directly into the urethra via a thin tube and spreads from there into the rest of the urinary system. To view the urethra and bladder, the doctor uses a cystoscope, a special instrument with a camera, which is inserted into the urethra.
Excretory urography
In excretory urography, the doctor does not administer the contrast agent to the patient directly via the urinary tract, but injects it into a vein. This is why this examination is also known as intravenous urography (intravenous urography). The kidney filters the contrast medium from the blood and excretes it via the urinary tract. The doctor can assess this process in the X-ray image.
Urography is used to diagnose the following clinical pictures:
- Kidney stones
- Cancer of the urinary tract
- Narrowing (stenosis) of the kidney or urinary tract
- Injuries to the renal pelvis
- Congenital malformations of the urinary tract
In addition, urography can be used to check the progress and success of the selected treatment in the urogram (follow-up).
Caution is advised in patients with a known intolerance to contrast media: As these tend to have severe side effects, the doctor must carefully weigh up whether the benefits of the examination outweigh the risks.
What do you do during a urography?
The patient is prepared the evening before the urography: The patient must not eat anything the evening before so that no intestinal gas or intestinal contents distort the X-ray image. The patient is also given laxative and decongestant medication. The patient should empty their bladder again immediately before the urography.
Retrograde urography
Before the urography, the doctor usually gives the patient a mild sedative and a painkiller. The patient is then placed in a supine position with their legs slightly bent and spread outwards, disinfected and covered with a sterile drape.
Excretory urography
Before the actual intravenous urogram, the radiologist takes a so-called blank image for comparison, i.e. an image without contrast medium. A contrast agent is administered to the patient via a venous access, which spreads through the blood vessels into the kidneys. After a few minutes, the doctor takes another image to assess the upper urinary tract. About a quarter of an hour after administering the contrast medium, the third image is taken, in which the spread of the contrast medium into the ureter and bladder can be seen. The entire examination usually takes about half an hour.
What are the risks of a urography?
As with many invasive diagnostic procedures, urography also involves certain risks, which the doctor informs the patient about in advance. Possible complications include injuries to the urethra, bladder, ureter or kidney, which can be caused either by the instruments or – in the case of retrograde urography – by pressure from the contrast medium.
What do I need to consider after a urography?
You should drink plenty of water or tea after the urography. This will help your kidneys to excrete the contrast medium remaining in your body.
If necessary, the doctor will prescribe an antibiotic. This is to prevent germs that may have entered the urethra with the cystoscope from spreading and causing ascending urinary tract infections.
Depending on the findings of the urography, the doctor will then discuss further treatment with you.
