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Urography | Diseases and conditions: Medical tests.

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What is Urography

Urography is a technique based on the x-ray that allows to study the urinary tract and its route. The urinary tract consists of the kidneys, ureters, bladder and urethra, and is in charge of purging the blood of toxins and waste products of metabolism. The test involves injecting dye into the bloodstream, which once inside spreads throughout the body and is filtered by the kidneys into the urine. X-ray we can see urinary tract drawn in the image.
This test was invented in Germany in the Decade of 1920 due to the development of the iodinated x-ray contrast. During their first years of life urography was used almost for any Urinary tract pathology, from obstructions to the diagnosis of cancer. Some of its uses has been displaced by ultrasonography and computed tomography, which allows, studying the anatomy of around with great precision, but still today is also essential for the study of nefriticos colic, to plan a ureters cancer surgery, or to diagnose malformations.
It is not a risk-free test, but complications are rare. The dose of radiation received is much higher than that received by a simple chest x-ray. Today will seek to use less aggressive for the patient techniques whenever possible, with a much higher for a more successful diagnostic image definition.

When doing a urography

A urography is performed when you want to study the urinary tract (kidneys, ureters, bladder or urethra), whether for diagnostic reasons (you want to detect or confirm any disease), or for planning interventions. Situations in which most commonly used urography are as follows:
Renal colic: happens when dissolved in the urine salts precipitate and form real stones that remain embedded in the urinary tract, obstructing the passage of urine. They produce big headaches, and to detect them it is not enough for an ultrasound or x-ray of abdomen, it takes many times a urography.
Ureteral stenosis: sometimes the ureters narrowed too much, favoring the interlocking of calculations and preventing the passage of urine. Its origin can be congenital (from birth) or caused by infection or surgery.
Malformation of the urinary tract: the urografico study allows us to visualize UTIs in their shape and size. Hypoplasias (lack of development) of any part of the urinary tract are sometimes given. Other times they may be to detect even a kidney of more or other benign disorders.
Internal holes: sometimes it is not easy to identify what is the point that urine loss is occurring. Urography allows you to see directly where the rupture of ureter or bladder that escapes the radiocontrast.
Blood loss: urinating blood can happen for many reasons, one of them is the active bleeding in some area of the urinary tract. You could see an arrival of iodinated contrast through a particular point much until it is filtered by the kidneys naturally.
Identification of tumors: a urography may help locate malignant and benign tumors, which your blood circulation is very irregular and differs in the kidney. Where tumors occur in the bladder or ureters notching iodinated contrast, as an occupation of the interior of the tract shall be respected
Surgery planning: urography is sometimes used before surgery of the urinary tract to be able to learn more about the anatomy of that region of the body. Today it is used very little thanks to the development of computed tomography (CT) and magnetic resonance imaging (MRI).

Preparation for urography

If you are performing a urography these are the issues that you must take into account:
Duration: urography can last more than one hour. Not only does it take to perform the test, but that preparation involved also quite some time. It calculates that you you must invest a morning or afternoon whole in testing you, approximately.
Income: usually not necessary to enter the hospital. After the test you will usually be hours in observation.
Is necessary to be accompanied?: Yes, it is recommended to carry a passenger. It is a test that is not without risk, and is better that there is someone to accompany you home when you are finished.
Drugs: you must tell your doctor all the medicines you take regularly and will decide which suspend or maintain. Sometimes the doctor will recommend you take medication that will help to carry out the test; typically the prescription of laxatives to clean colon and which hinders not the visualization of the kidneys. The doctor will ask if you have antidiabetic oral, since otherwise they must check the proper functioning of your kidneys.
Food: is better to remain in fasting 8 hours before the test.
Clothes: you can go to the test with the same clothes every day. For the test you will be prompted that you take it off and they will put a robe of income which is more hygienic and comfortable to be able to test you.
Documents: it is recommended to carry the personal medical history, although the doctor will already have it with him. Before put you to the test you will sign the informed consent with which you agree to make yourself the technique and you will know the potential risks, which are rare. They will also make you a series of basic tests before the urography, such as an electrocardiogram or a blood analysis; take the results with you if you have taken them.
Pregnancy and breast-feeding: urography is contraindicated in these situations. If there is a minimal chance of being pregnant not you should submit to this test, since exposure to X rays and the radiocontrast may harm the fetus. Usually the doctor performed a pregnancy test prior to women who do not deny being pregnant.
Breast-feeding is not a contraindication direct, but is best avoided the test until the end the period of breast feeding, unless strictly necessary.
Contraindications: pregnancy is a contraindication for this test. It should not be if you have chronic kidney damage, since the radiocontrast can disable them. People who have an active infection nor should undergo this test if it is not strictly necessary.

How urography

Firstly they will ask you if you're in agreement with submit to urography and you will be asked to sign the informed consent, where you will read what is the test. You cite that you submit to the test another day and explain how you have to keep the appointment.
For the test to attend directly in the morning; You must not forget to stay in fasting 8 hours before. The days leading up to the test will give you a few dietary recommendations to keep the colon clean (fiber one week prior to the test, and then soft diet with soups). Go to the quiet and accompanied, hospital with enough time so you're not stressed before the test. Before entering the room where you will be urography ask you that you change your clothes and give you a batin's hospital. Once inside you will see multiple monitors and a table where you tumbarás you face up.
Before starting the intervention you will you a sleeve on the arm to control blood pressure, several electrodes on the chest to control heart rate, and a venous pathway on the other arm to inject you with iodinated contrast. To inject it you will feel heat on the punctured arm and also generalized flushing. This is normal and you should not alarm you. It is also frequent that you notice a metallic taste in the mouth that lasts a few seconds.
Once injected contrast you must remain still. The radiologist will make you x-rays serial low-intensity, so will take photos of the urinary tract painted by contrast at different stages. If you move those pictures come out blurry and will have to do more. This part of the test lasts several minutes, until all the contrast has been leaked by the kidneys and has expelled by urine.
Finally, you will go to another room so that rest of the test and will keep you under surveillance a while. You will be asked to drink plenty of water, both in the hospital and at home; that is the best way to cleanse your body of the contrast and prevent acute kidney damage. Before you leave the hospital, they will ask you that you urinate to see the appearance of the urine and check so it's normal.

Complications of urography

Urography complications are very rare. He is usually discarded the test to people who may have a high risk of adverse effects. Some of the complications that can occur on occasions are:
  • Upset, nausea and vomiting
  • Fainting and loss of consciousness
  • Headache.
  • Disorders of the thyroid gland.
  • Changes of blood pressure suddenly
  • The x-ray contrast medium allergic reaction
  • Serious acute renal failure.
  • Local clots and embolisms
  • Metabolic acidosis.

Results from the urography

Nothing else done urography because you can see the same data. When the urinary tract are intact are observed well outlined, no nicks or loss of contrast.
Urography results They are obtained in several phases: a first part of initial filter that allows to study the kidneys, the following would be more advanced and with it are studied more thoroughly the kidneys and part more initial ureters, after the passage of the contrast by the ureters, and finally, the retention of urine in the bladder.
However, small changes in the test may be misinterpreted if rapid diagnosis. Therefore, it is best that the radiologist or the doctor who carried out the urography carefully study it and assess it in relation to the rest of the evidence that you made.
More typically, a few days after the test have a consultation with the doctor. There he will discuss to what have been the results of the test and will inform you a diagnosis and treatment if the test has been altered and is final.
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