Intravenous Urography Examination Research Articles

Does bowel preparation improve the quality of intravenous urography?

Many radiology departments continue to use bowel preparation prior to intravenous urography (IVU) despite recent studies questioning its value. This prospective study was designed to test the hypothesis that bowel preparation does not affect the quality of IVU, the number of films taken, or the use of tomography. 144 patients were randomized into three groups; 49 had no preparation, 48 received a mild stimulant laxative (Dulcolax), and 47 took an osmotic laxative (Citramag). The subsequent IVUs were then reviewed by two observers; the control and contrast films were scored for the presence of faecal residue, and the visibility of the renal tract, respectively. Patients were also questioned about the side effects of the two preparations. There was no significant difference in the scores for renal tract visibility in those patients receiving stimulant laxative when compared with the unprepared group. Those receiving the osmotic laxative had significantly less faecal residue but this was at the expense of an increased amount of bowel gas. The osmotic laxative group had significantly higher scores, indicating better visualization of the urinary tract, than the other groups, but no significant reduction in the number of radiographs taken or the use of tomography. This group also reported more side effects. Overall our results suggest that the routine use of a laxative prior to an IVU examination does not decrease the radiation dose and produces some patient inconvenience. The practice therefore cannot be routinely recommended.

Ultrasound of the pelvis and renal tract combined with a plain film of abdomen in young women with urinary tract infection: can it replace intravenous urography? A prospective study

Urinary tract infection (UTI) is common in women and intravenous urography (IVU) is a frequently requested radiological investigation for recurrent UTI. The aim of this study was to assess whether pelvic and renal ultrasound combined with a plain film of the abdomen (KUB) could replace IVU as the initial radiological investigation in young women with recurrent UTI. Ninety-four young women with recurrent UTI who were referred for IVU were studied. Ultrasound of the pelvis and renal tract was performed, and information obtained from ultrasound and KUB was compared with that obtained from the IVU examination. Patient management was altered as a result of radiological investigation in eight cases. A case of staghorn calculus and a case of pelviureteric junction obstruction were diagnosed by both IVU and ultrasound with KUB. An intrarenal abscess was diagnosed by ultrasound in a patient with a normal IVU. In addition ultrasound demonstrated significant findings in the pelvis, including ovarian and uterine abnormalities and an ectopic and an intrauterine pregnancy. In all cases the patient had symptoms referable to the urinary tract and a history of documented UTI. The KUB did not yield any unsuspected finding not diagnosed by ultrasound, but did serve to delineate more clearly the extent of calculus disease in two patients. We suggest that ultrasound of the pelvis and renal tract combined with a KUB should be the radiological investigation of choice in young women with UTI.