Name of the Procedure:

Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter

Summary

Ureterography or ureteropyelography involves injecting contrast dye into the ureters to visualize the urinary tract on imaging studies. This can be done through a ureterostomy, which is a surgically created opening in the ureter, or through an indwelling ureteral catheter that has already been placed.

Purpose

The procedure is performed to diagnose or assess issues with the ureters and kidneys, such as blockages, stones, or structural abnormalities. The goal is to obtain clear imaging of the urinary tract to guide further treatment or surgical planning.

Indications

• Unexplained hematuria (blood in urine)
• Suspected ureteral obstruction or kidney stones
• Recurrent urinary tract infections
• Evaluation of congenital urinary tract anomalies
• Monitoring the progress of certain treatments or surgical outcomes

Preparation

• Fasting may be required for a few hours prior to the procedure.
• Patients should inform their doctor about any allergies, particularly to contrast dye or iodine.
• Pre-procedure tests may include blood work and imaging studies.
• Patients may need to adjust or withhold certain medications, especially blood thinners.

Procedure Description

1. The patient is positioned comfortably, and the area is cleaned and sterilized.
2. Local anesthesia is administered to minimize discomfort.
3. If using a catheter, it is accessed and flushed; if using a ureterostomy, the opening is prepared.
4. A contrast dye is injected through the catheter or ureterostomy.
5. X-ray or fluoroscopic images are taken to track the dye and visualize the ureters and kidneys.
6. The tools used include a catheter or ureterostomy tube, contrast dye, and imaging equipment.
7. Monitoring is continuous to ensure patient safety during the procedure.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

It is usually performed in a hospital's radiology department or an outpatient clinic equipped with imaging facilities.

Personnel

• Radiologist or urologist (performs the procedure)
• Radiologic technologist
• Nurses (assist with prep and patient care)
• Anesthesiologist (if sedation is required)

Risks and Complications

• Allergic reaction to contrast dye
• Infection at the injection site
• Bleeding or injury to the ureter
• Rarely, contrast-induced nephropathy (kidney damage)

Benefits

• Accurate diagnosis of urinary tract issues
• Clear visualization for surgical planning
• Minimal invasiveness compared to surgical exploration

Recovery

• Patients may experience mild discomfort or soreness at the injection site.
• Monitoring for a short period after the procedure is common.
• Normal activities can usually be resumed shortly after, but heavy lifting or strenuous activities might be limited for a day or two.
• Follow-up appointments may be scheduled to discuss results and next steps.

Alternatives

• Ultrasound: Non-invasive but may provide less detailed images.
• MRI or CT scan: Provides alternative imaging but may be less specific.
• Endoscopic procedures: More invasive but can allow for therapeutic interventions.

Patient Experience

Patients might feel a brief sting from the anesthesia and pressure during the dye injection. Mild discomfort or cramping can occur but is generally well-managed with medication. Post-procedure care ensures any side effects are swiftly addressed, and pain is minimized.