Intravenous Pyelogram (IVP)

What is an intravenous pyelogram (IVP)?

An intravenous pyelogram (IVP) is an X-ray that reveals how your kidneys and urinary tract handle fluid waste. Also known as intravenous urography, healthcare providers use intravenous pyelogram to diagnose problems in your kidneys, ureters and bladder.

An X-ray takes a picture of the inside of your body by delivering a small dose of radiation. With IVP, a healthcare provider injects a special dye (iodinated contrast material) into your vein. The dye travels through your blood to your kidneys, ureters and bladder. Those body parts (your kidneys and urinary tract) appear white on the IVP images.

Today, it's more common for healthcare providers to use:

• Ultrasound to diagnose problems with your kidneys and urinary tract without a contrast injection.
• Computed tomography (CT) scans with or without intravenous iodinated contrast dye.
• Magnetic resonance imaging (MRI) scanswith or without gadolinium contrast dye, which provide more complete and detailed three-dimensional images of your kidneys and urinary tract.

What was intravenous pyelogram (IVP) historically used for?

Intravenous pyelograms helped healthcare providers diagnose several conditions, including:

• Kidney stones.
• An enlarged prostate.
• Tumors or cysts of the kidneys, bladder and/or ureters.
• Scarring from a urinary tract infection.
• Congenital anomalies of the urinary tract. (“Congenital” means you’re born with it.)

Healthcare providers don't use intravenous pyelograms very much anymore. They usually order ultrasounds, CT scans or MRI scans to diagnose kidney and urinary tract conditions.

When is intravenous pyelogram performed?

Healthcare providers may order imaging of your kidneys or urinary tract if you have symptoms such as:

• Blood in your pee (urine).
• Cloudy urine.
• Lower back pain.
• Pain in your side.

These symptoms may mean there’s an issue with your kidneys or urinary tract.

Who performs intravenous pyelogram?

X-ray technicians and radiologists perform intravenous pyelograms. Radiologists interpret the results and report them to your healthcare provider.

What makes up your kidneys and urinary tract?

Your kidneys and urinary tract consist of:

• Kidneys: You have two kidneys that filter blood, remove waste and create urine.
• Ureters: You have a pair of tubes that transport urine from your kidneys to your bladder.
• Bladder: Your bladder is a hollow reservoir that stores urine.

Your healthcare provider can see these body parts with an intravenous pyelogram, though they’re more likely to order an ultrasound, CT scan or MRI scan. Imaging helps providers diagnose stones, cysts and other medical issues.

What’s the procedure for an intravenous pyelogram (IVP) test?

Intravenous pyelogram isn’t used very much anymore. But the procedure remains unchanged. There are several steps to the intravenous pyelogram. An X-ray technician or radiologist will:

• Have you lie on your back under an X-ray machine to get a picture of your belly (abdomen) and pelvis before the contrast dye.
• Inject the dye into your vein.
• Ask you to lie back down for several X-rays as the contrast dye filters through your kidneys and passes through your ureters and bladder.
• Give you a break to empty your bladder once more.
• Take a few more pictures with you lying on your back.

What are the complications of an intravenous pyelogram?

Most people experience one or more common, temporary symptoms when the X-ray technician or radiologist injects the dye. Symptoms may include:

• A minor sting with the injection.
• A flush of warmth.
• A mild itching sensation.
• A mild metallic taste.

Three to 13 people out of 100 experience a minor, temporary abnormal response to the intravenous pyelogram dye. Symptoms may include:

• Nausea.
• Vomiting.
• Feeling flushed (your face, chest or neck turn red).

Severe reactions to the contrast dye are rare. These problems include:

• Breathing difficulties.
• Low blood pressure.
• Hives.
• Swelling in your mouth or throat.
• Cardiac arrest.

You're more likely to have an adverse reaction to the intravenous pyelogram dye if you have a history of certain medical conditions, including:

• Allergies.
• Congestive heart failure.
• Diabetes mellitus.
• Chronic kidney disease.

Today, your healthcare provider will likely order alternative, less invasive tests to help diagnose your condition.

How long does an intravenous pyelogram last?

An intravenous pyelogram typically takes about an hour. It may take longer if you have kidneys that function slowly.

How long is the recovery time?

Recovery time is minimal and involves drinking lots of fluids after the test to flush the dye out of your system.

When should I contact my healthcare provider?

Contact your healthcare provider if you experience any of the following symptoms, as they could indicate an issue with your kidneys, ureters and/or bladder:

• Blood in your urine.
• Cloudy urine.
• Lower back pain.
• Pain in your side.

Also, if you think you’re having a severe allergic reaction (anaphylaxis) to contrast dye or anything else, contact your provider or go to the emergency department.

A note from Cleveland Clinic

If you have blood in your urine, cloudy urine, pain in your side or lower back pain, your healthcare provider may order imaging tests to help identify any problems in your kidneys or bladder, such as cysts or kidney stones. The intravenous pyelogram, a type of X-ray, is now rarely used for this purpose. Instead, providers use ultrasound, CT scans and/or MRI scans, which are less invasive.

• MedlinePlus. Intravenous Pyelogram. Accessed 8/2/2022.
• Mehta SR, Annamaraju P. Intravenous Pyelogram. 2022 May 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. Accessed 8/2/2022.
• Radiology Info. Intravenous Pyelogram. Accessed 8/2/2022.