Urography, infusion, drip technique and/or bolus technique
CPT4 code
Name of the Procedure:
Urography, infusion, drip technique and/or bolus technique (Intravenous Pyelogram - IVP).
Summary
Urography, also known as an Intravenous Pyelogram (IVP), is an imaging procedure where a dye is injected into a vein and X-rays are taken to assess the kidneys, ureters, and bladder. This can be done using either a drip infusion or a bolus injection technique.
Purpose
The procedure is used to evaluate the urinary tract for abnormalities such as kidney stones, tumors, or blockages. The goal is to provide clear images that help in diagnosing conditions affecting the urinary system.
Indications
- Presence of blood in urine (hematuria)
- Recurrent urinary tract infections
- Flank pain
- Suspected kidney stones or tumors
- Assessment of structural abnormalities or injuries to the urinary tract
Preparation
- Patients may be asked to fast for several hours before the procedure.
- A bowel-cleansing preparation might be recommended to clear the intestines.
- Patients need to inform their doctor about any allergies, especially to iodine or contrast media.
- Pre-procedure lab tests might include kidney function tests.
Procedure Description
Infusion/Drip Technique:
- Contrast dye is gradually infused into a vein, usually in the arm.
- A series of X-rays is taken over a period to track the dye's progress through the urinary tract.
Bolus Technique:
- Contrast dye is injected rapidly into a vein.
- X-rays are taken quickly after the injection to capture the dye moving through the urinary tract.
Tools and Equipment:
- Contrast medium (iodine-based dye)
- X-ray machine
- IV apparatus for administering contrast
Anesthesia: Generally not required, but some patients might receive a mild sedative.
Duration
The procedure typically takes between 30 to 60 minutes, depending on whether additional imaging is necessary.
Setting
Usually performed in a hospital's radiology department or a specialized outpatient imaging center.
Personnel
- Radiologist
- Radiologic technologist
- Nursing staff, if sedation or additional support is required
Risks and Complications
- Allergic reaction to the contrast dye
- Kidney dysfunction due to the dye
- Pain or discomfort at the injection site
- Rarely, complications like infection or vein inflammation
Benefits
- Accurate diagnosis of urinary tract conditions
- Non-invasive with relatively quick results
- Helps guide treatment planning
Recovery
- Patients can usually resume normal activities immediately.
- They might be advised to drink plenty of fluids to help flush out the contrast dye.
- Follow-up appointments may be scheduled to review the results.
Alternatives
- Ultrasound: No need for contrast medium, but less detailed images.
- CT Scan: More detailed images, but higher radiation exposure.
- MRI: Detailed images without radiation, but more expensive and time-consuming.
Patient Experience
- Some patients might feel a warm sensation or a metallic taste when the contrast dye is injected.
- Mild discomfort at the injection site is possible.
- Post-procedure, the patient should drink plenty of water to help clear the dye from their system.
- Pain is typically minimal, and any discomfort can be managed with common pain relievers.