RETROGRADE PYELOGRAM
Presented by: Jauna Aurelle H. Lopez
RPG
Is a type of x-ray that allows visualization of the bladder, ureters, and renal pelvis. Contrast dye can be introduced into the ureters via a catheter.
Reasons for the procedure:
It maybe use in persons suspected to have an obstruction such as tumor, stone, blood clot, or stricture in the kidneys or ureters. It is also used to evaluate placement of a catheter or uretheral stent. An advantage of RPG is that it can be performed even if the patient is allergic to contrast dye. This procedure may also be perform on patient with impaired kidney function.
Risks of the procedure:
The amt. of radiation used during a RPG is considered minimal. If you are pregnant or suspect that you may be pregnant, you should notify your physician. contrast dye is used, there is a risk for allergic reaction to the dye. Patients who are sensitive to medications, contrast dye, iodine, or shellfish should notify their physician.
Patients with kidney failure or other kidney problems should notify their physician. Possible complications of RPG, but are not limited to, sepsis, urinary tract infection, bladder perforation, hemorrhage, nausea and vomiting. May be contraindicated for patients experiencing severe dehydration.
Certain factors or conditions may interfere with a RPG. These factors include, but are not limited to, the following: Feces or gas in bowel
Before the Procedure
The physician will explain the procedure and offer the opportunity to ask any questions that you may have about the procedure. You will be asked to sign a consent form that gives permission to do the procedure. You will need to fast for a certain period of the time prior to the procedure. If you are pregnant or suspect that you may be pregnant, you should notify your physician.
Notify your physician if you have ever had a reaction to any contrast dye, or if you are allergic to iodine or seafood. Notify your physician if you are sensitive to or are allergic to any medications, latex, tape, and your anesthetic agents. Notify your physician of all medications and herbal supplements that you are taking. Notify the physician if you have a history of bleeding disorders or if you are taking any anticoagulant.
A laxative may be prescribed at night and a cleansing enema or suppository may be given a few hours before the procedure. You may receive a sedative prior to the procedure to help you relax Based upon your medical condition, your physician may request other specific preparation.
During the procedure:
You will be asked to remove any clothing, jewelry, or other objects that may interfere with the procedure. If you are asked to remove clothing, you will be given a gown to wear. An IV line maybe inserted in your arm or hand. You will be ask to lie face up on the x-ray table and place your legs in stirrups. You may receive a sedative in the IV prior to the insertion of the endoscope.
An endoscope will be inserted through the urethral opening and advanced into the bladder. Once the endoscope is in place, the bladder can be examined and the catheter may be inserted into one or both ureter. The contrast dye will be injected through the catheter. A series of x-rays will be taken at time interval. The catheter will be removed. The physician will check for retention of the contrast dye.
After the procedure:
Notify your physician to report any of the following:
Fever Redness, swelling, or bleeding or other drainage from the urinary opening. Increase pain around the urinary opening. Increase in the amount of blood in the urine. Difficulty in urinating.