5. In Radiology Intravenous Pyelogram / Urogram is the Radiographic study of the renal parenchyma, pelvicalyceal system, ureters and the urinary bladder. The Purpose of Intravenous Pyelogram / Intravenous Urogram:  To opacify the urinary system's collecting portion.  To access the functional ability of the two kidneys.  Evaluate a pathology or anatomic anomalies in the urinary system.  Check the course of the ureters.  Detect and localize a ureteric obstruction.  Assess for synchronous upper tract disease in those with bladder transitional cell carcinoma (TCC).

7. 10. There is slight risk of having an allergic reaction to the contrast material. The reaction Can be mild (itching, rash) or severe (trouble breathing or sudden shock). Death resulting From an allergic reaction is very rare. 11. To avoid any Problems that occur from Contrast Media we may do this: The smallest amount of contrast agent possible should be used for each procedure. Hydration: take 500 mL of water before the procedure and 2,500 mL over the 24 hours after the procedure. Non-renal reactions to contrast material can be reduced by premedication the patient with corticosteroids. Furosemide (Lasix) has not been shown to prevent contrast-induced renal failure. 12. On the day of procedure take a scout/plain film to check patient preparation, Positioning and also For radio-opaque calculi. 13. After Care: Resume your normal diet and drink plenty of water to flush the contrast material out of your system. 14. If you are diabetic and take Glucophage (an oral hypoglycemic medication), you may take the medicine before the x-ray examination but cannot resume taking it for at least 48 hours after the study is completed.

8. 1. Preliminary Films: Abdomen - AP Supine (KUB). Check with radiologist. 2. Inject Contrast Media: Immediate Tomogram - Renal Area (Nephrogram). 5 minute plain film - Renal Area. Compression may be applied at this stage (applied over distal ends of Ureters; that inhibits flow of urine into Bladder). 10 to 15 Minutes - AP Abdomen Supine. Abdomen - Obliques (RPO + LPO). AP Abdomen – Bladder Area - Full Bladder. AP Abdomen - Post Maturation. 3. Supplementary Views Renal Area views with compression. Abdomen - AP Supine - full length release (when removing compression). Abdomen - PA Prone. Bladder - Obliques (RPO + LPO) or Lateral. Inspiration / Expiration oblique Renal Area. Delayed films to determine site of Ureteric Obstruction.

9. In general: Ensure the removal of artifacts that may superimpose the anatomy of interest. Respiration: Suspended on expiration - this lifts the diaphragm and presents the abdominal contents in a more relaxed state. Exposure Factors: 75 kVp, 35 mAs. Cassette (IR) Size: 35 x 43 cm. Cassette Orientation: Portrait (Lengthwise). FFD / SID: 100cm, (40 in). Always using Bucky (Grid). Positioning: 1.Patient is supine on the table. 2.Cushion for head. 3.Patient's arms slightly abducted from the torso. 4.Positioned without rotation of the pelvis and torso. 5.Ensure there are no artifacts such as zips or buttons over the area being imaged. 6.Centre the midsagittal plane of the patient to the midline of the IR. Central Point: Directed to the midsagittal plane at the level of the Iliac Crests. Central Ray: Perpendicular to the IR.

11.  Patient is Supine.  CR to Lower Costal Margin.

12.  Patient is Supine.  CR to Lower Costal Margin.

13.  Patient is Supine.  Compression Device should be centered at ASIS.  Applied over distal ends of Ureters; that inhibits flow of urine into Bladder.  Center Point: 2 in Superior to Pubic Symphysis.

15.  Patient is Supine.  Patient rotated to 30º.  CR to Iliac Crest, 2in lateral to Midsagittal Line into the side up.

16.  Patient is Supine.  CR Angled 10º - 15º Caudal.  Center Point: 2 in Superior to Pubic Symphysis.