How is an intravenous urography test performed?

  Intravenous urography is an examination of the integrity of the urinary tract system by means of contrast agent injected intravenously, filtered through the glomerulus and then through the ureter to the bladder, and is one of the good methods for the diagnosis of urinary tract stones and tumors. It is complementary to ultrasound in the evaluation of obstructive uropathy. It is not specific for the diagnosis of renal parenchymal disease. When performing intravenous urography, attention must be paid to whether the patient will have an allergic reaction to the contrast agent. The chance of acute renal failure is high in patients with renal insufficiency; in addition, the urinary system is not easily visualized when the urinary creatinine clearance rate is less than 30 ml per minute, so this test is contraindicated in cases of severely impaired renal function, liver disorders and heart disease, and should be performed with caution.  When performing intravenous urography, the patient lies flat on the examination bed, and after the doctor has adjusted the abdominal compression site and pressure, the nurse pumps the contrast agent into the syringe to exhaust the air, selects a suitable local vein for skin disinfection and puncture, and slowly injects 40 ml of contrast agent without interruption after successful injection, withdraws the needle after injection, and covers the puncture site with sterile adhesive tape under pressure.  In adults, after contrast injection, the ureter is compressed and one film is taken at the 7th, 15th and 30th minutes. The last plain film includes the kidney and ureter to the bladder, and additional films are taken if necessary. In children, the number of photographs should be reduced. In addition to the flat film, one photograph of the kidneys should be taken at the 3rd to 5th minutes after injection, and the second one should be taken at the 7th to 12th minutes, including the kidneys, ureters and bladder.