74420 Urography, retrograde, with or without KUB

Name of the Procedure:

Urography, retrograde, with or without KUB (Kidneys, Ureters, and Bladder X-ray)

Summary

Retrograde urography is a diagnostic imaging procedure used to visualize the urinary tract, which includes the kidneys, ureters, and bladder. This procedure involves inserting a catheter through the urethra into the bladder and injecting a contrast dye to make the urinary tract visible on X-ray images.

Purpose

Retrograde urography is performed to evaluate and diagnose various urinary tract conditions such as blockages, tumors, stones, congenital anomalies, or injury. The goals include detailed imaging of the urinary tract to assist in diagnosis and provide guidance for treatment decisions.

Indications

• Persistent urinary tract infections (UTIs)
• Hematuria (blood in the urine)
• Suspicion of structural abnormalities or tumors in the urinary tract
• Obstructions in the urinary tract
• Evaluation of ureteral stents or surgical outcomes

Preparation

• Patient may be instructed to fast for several hours before the procedure.
• Bowel prep may be required to clear out the intestines for better imaging.
• The patient should inform the healthcare provider about any allergies, especially to contrast material, medications, or iodine.
• A pre-procedure assessment of kidney function is often performed.

Procedure Description

1. The patient receives a sedative or local anesthesia.
2. A catheter is gently inserted through the urethra into the bladder.
3. Contrast dye is injected through the catheter.
4. X-rays are taken to capture detailed images of the urinary tract.
5. The catheter is removed, and the patient may be asked to empty their bladder before completing the imaging.

Tools used: catheter, contrast dye, X-ray machine. Sedation: Local anesthesia or mild sedative if needed.

Duration

The procedure typically takes 30 to 60 minutes.

Setting

Performed in a hospital, outpatient clinic, or specialized radiology center.

Personnel

• Radiologist or urologist
• Radiologic technologist
• Nurse

Risks and Complications

• Allergic reaction to contrast dye
• Infection at the catheter insertion site
• Minor discomfort or pain during catheter insertion
• Rarely, damage to the urinary tract

Benefits

• Provides detailed imaging of the urinary tract structures.
• Helps diagnose and guide treatment for urinary tract conditions.
• Immediate visualization and information for accurate diagnosis.

Recovery

• Patients can often go home shortly after the procedure.
• Increased fluid intake is encouraged to help flush out the contrast dye.
• Mild discomfort or burning sensation during urination may occur but usually resolves quickly.
• Follow-up appointments may be scheduled to discuss findings and treatment options.

Alternatives

• Intravenous pyelogram (IVP) - a similar imaging test using intravenous contrast dye.
• Ultrasound - non-invasive imaging without contrast dye.
• CT scan or MRI - more detailed imaging, often used if retrograde urography is inconclusive.
• Each alternative has its own pros and cons, such as differences in detail, invasiveness, and contrast use.

Patient Experience

During the procedure, patients may feel pressure or mild discomfort from the catheter. Post-procedure, a burning sensation during urination is common but generally subsides quickly. Pain management includes over-the-counter pain relief if needed, and measures to ensure patient comfort throughout the process are prioritized.