Pyelography - antegrade and retrograde techniques


1. When appointed?

2. Contraindications

3. How to prepare?

pyelography is an instrumental method of diagnosis, which allows you to obtain X-ray images of the ureters after a preliminary introduction to their clearance a special marker.This study is usually prescribed for urinary tract obstruction.This procedure is of two kinds - descending (antegrade) and rising (retrograde).

Retrograde pyelography allows health professionals to obtain a clear image of the ureter, renal pelvis and calyces.For this study, using gaseous substances (oxygen and carbon dioxide) and the liquid contrasts (kardiotrasta solutions sergozina, and triyotrasta Diodon).

Retrograde pyelography is usually performed only by one-sided, as the simultaneous study of both ureters causes spasms pelvis and cups, which is quite difficult tolerated.For administration of contrast using a special catheter, the diameter of which is selected depending on the degree of narrowing of the ureter.The pelvis adult patient

is administered about 5 ml of liquid contrast.To prevent pain in the test, a marker drug is warmed to body temperature.The injection is carried out very slowly.

Antegrade pyelography is based on the introduction of contrast in pyelocaliceal system by percutaneous puncture or through nefropielostomu.This study, in most cases, is assigned when ascending pyelography can not be performed (for example, with obstruction of the ureter or urethra, small capacity of the bladder).

Antegrade pyelography with contrast administration through nefropielostomu is a fairly simple manipulation.It is usually prescribed to control post-operative state of the ureter and renal pelvis system.

percutaneous needle descending pyelography is performed under local anesthesia in the prone position.

When he appointed?

main indications for pyelography are:

  • stone in the urethra or ureter.
  • adjacent organs tumor pressing on the urinary tract.
  • spasm of the ureter.
  • hydronephrosis of unknown etiology.
  • Urological diseases, provoking a sharp decrease in the function of the renal parenchyma, which do not allow to perform retrograde pyelography and excretory urography (tuberculosis of the bladder, ureter, kidney, ureteral stricture, ureteral tumor occluding).
  • definition of patency of the upper urinary tract.
  • Determination of toning pyelocaliceal system.
  • Postoperative control of the state of the ureter and renal pelvis system.

Contraindications The main contraindications to pyelography are:

  • coagulation disorders;
  • suspected tumor in the kidney;
  • paranephritis;
  • idiosyncrasy of radiopaque agents.

How to prepare?

antegrade and retrograde pyelography does not require special preparation of the patient.A necessary condition is the strict observance of sterility.

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