Your provider might order a retrograde pyelogram to see what’s going on if you have symptoms of stones or blockages in your urinary system. The procedure generally requires anesthesia.
A retrograde pyelogram is an image created by combining X-rays with a dye injected into the ureters to get clear pictures of the parts of your urinary system. The dye is a contrast agent that makes the pictures easier to understand. The procedure can be used on one or both ureters.
The “retrograde” means that the flow is going back into your system, rather than outward as liquid (urine) normally flows. The “pyelogram” refers to the images of a specific part of your kidney, the renal pelvis, an area near where the ureter is attached. Another name for this procedure is retrograde pyeloureterogram.
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Another test, an intravenous pyelogram, is similar, but the dye is put into your vein instead of into your ureter. They involve using contrast dyes and both are used to show images of the upper urinary tract. A retrograde pyelogram is done when you’re allergic to contrast media and it can’t be injected into your vein.
Intravenous pyelograms aren’t used as often as they were. Providers now prefer to do computed tomography (CT) urograms to find bleeding, blockages or tumors.
Your provider might order a retrograde pyelogram if:
Retrograde pyelography was used in the past more often than it is now. It’s been replaced in many cases by other imaging technologies. However, it still is used with cystoscopy in many cases, such as stenting to keep passageways open.
Before you have the procedure, you’ll talk with your doctor about your symptoms, your medical condition and the medicines and over-the-counter products you’re taking. It’s especially important that your doctor knows about pregnancy, blood-thinner medications and allergies.
This procedure typically is an outpatient procedure done in a hospital or walk-in surgery setting. It’s likely that you’ll get some type of anesthesia, usually general, so you’ll need a driver.
Your healthcare provider will tell you if and when you’ll have to stop eating and drinking the night before the procedure and if you’re able to take your usual medications.
On the day of your procedure, leave your jewelry and valuables at home. Don’t bother with lotions or makeup. Wear loose and comfortable clothing.
Here are some advantages to having a retrograde pyelogram:
No procedure is without risk, but retrograde pyelograms are very safe. Risks include:
Your recovery may depend on whether or not your provider performed other procedures, but you should be able to go back to work or school in a few days.
You can return to normal eating, and you should stay hydrated.
Call your healthcare provider after a retrograde pyelogram if you:
A note from Cleveland Clinic
If your healthcare provider thinks that you may have a blockage in the upper part of your urinary tract, like in the ureter, they may suggest that you have a retrograde pyelogram. This procedure can be combined with cystoscopy to diagnose and treat your urinary condition.
Last reviewed by a Cleveland Clinic medical professional on 04/11/2022.
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