Intravenous Pyelogram (IVP)

What is an intravenous pyelogram?

An intravenous pyelogram (in-truh-VEE-nuhs pahy-EL-uh-gram) is a type of imaging test. It shows how your urinary system handles pee. It can help diagnose problems in your kidneys, ureters and urinary bladder.

During the test, healthcare providers inject a contrast dye into a vein. The dye travels through your blood to your urinary system. X-rays pick up the dye, which makes the parts of your urinary system look white in the images.

Other names for an intravenous pyelogram include:

• Intravenous pyelography
• IVP
• Intravenous urography
• IV urography

Today, intravenous pyelogram isn’t common. Healthcare providers are more likely to recommend other imaging tests, like:

• CT scan
• MRI
• Ultrasound

What might it be used for?

Healthcare providers rarely perform IVP. But in the past, they may have recommended IVP to diagnose:

• Cysts or tumors in your urinary system
• Enlarged prostate (benign prostatic hyperplasia)
• Kidney stones
• Problems in your urinary system that you have at birth (congenital urinary abnormalities)
• Scarring from a urinary tract infection (UTI)

Providers sometimes recommend IVP to help diagnose:

• Medullary sponge kidney
• Renal papillary necrosis

How do you prepare for an intravenous pyelogram?

Healthcare providers will review your medical history before an IVP. Be sure to tell them if you:

• Are pregnant or think you may be pregnant
• Have allergies to skin cleaners like iodine or isopropyl alcohol
• Have had a reaction to contrast dyes before

Your provider will also give you specific instructions on eating or drinking before an IVP. And they may recommend taking a laxative so you poop. Empty bowels can make it easier for your provider to see any problems in your images.

Do you need a full bladder?

No. You should pee right before the test. This makes it easier for healthcare providers to see the contrast dye in your urinary system.

Who performs it?

A radiologist or radiologic technologist will perform an intravenous pyelogram. Radiologists are medical doctors who specialize in diagnosing conditions using imaging tests. Radiologic technologists aren’t doctors. But they can perform some tests, including IVPs.

What to expect during the test

In general, your healthcare provider will:

1. Place a peripheral IV into a vein, usually in your arm
2. Place you face-up on your back to get a picture of your belly and pelvis before you get contrast dye
3. Inject contrast dye into your vein
4. Take several X-rays as the dye filters through your kidneys and passes through your ureters and bladder
5. Ask you to pee again to see if your bladder completely empties
6. Take more X-rays after you pee

An IVP usually takes about an hour, and you should lie still as they take the images. But it may take longer if your kidneys function slowly.

What to expect after the test

Afterward, your healthcare provider will remove the peripheral IV from your arm. They’ll place a bandage over the area where the needle went in. They’ll also encourage you to drink lots of fluids. Drinking fluids, especially water, helps flush the dye out of your system. Afterward, you can continue your regular activities.

What are the risks?

You’ll likely feel some symptoms after your healthcare provider injects the dye. These symptoms usually don’t last long. They may include:

• A mild pinch or sting
• A flush of warmth
• Mild itching
• A metallic taste in your mouth

In some cases, you may feel nauseous or throw up. Your face may also feel flushed.

Severe allergic reactions to contrast dye are rare. But they’re possible. They may include:

• Trouble breathing
• Low blood pressure
• Hives
• Swelling in your mouth or throat

Healthcare providers may not recommend IVP if you have:

• Poor kidney function, which increases your risk of acute kidney injury (AKI)
• Barium in your intestines, which can interfere with the imaging (providers may use oral barium in some imaging tests, like a CT scan of your abdomen)

What type of results do you get and what do the results mean?

It depends on the conditions that affect your urinary system. An IVP may reveal:

• Unexpected shape, size or position of the organs in your urinary system
• An enlarged prostate gland
• Blockages
• Cysts or tumors
• Damage or scarring

A radiologist will look for anything unexpected in the images. They’ll then report to the healthcare provider who recommended an IVP. Your provider will contact you to explain the results. They’ll also discuss any next steps in your treatment.

When should I know the results of the test?

You should expect to get your results within a few days.

If the results are abnormal, what are the next steps?

If your results are abnormal, your healthcare provider may recommend more tests. Tests may include:

• An ultrasound, MRI and/or CT scan
• Kidney function tests
• Kidney or bladder biopsy

They may also recommend treatment.

When should I call my doctor?

After your IVP, call your healthcare provider if you have any symptoms that may point to problems with your urinary system. These may include:

• Blood in your pee (hematuria)
• Cloudy pee
• Flank pain
• Lower back pain

Get to the nearest emergency room if you show signs of a severe allergic reaction to contrast dye.

What is the difference between IVP and IVU?

There’s no difference between an intravenous pyelogram and an intravenous urogram (IVU). They’re different names for the same test.