INTRAVENOUS UROGRAPHY

Intravenous Urography (IVU)

• Definition: Intravenous urography is a radiological imaging technique used to visualize the urinary system, including the kidneys, ureters, and bladder.

• Procedure: 1 → A contrast medium is injected into a vein in the arm. 2 → The contrast medium flows through the bloodstream and is excreted by the kidneys into the urine. 3 → X-rays are taken as the contrast medium passes through the urinary system, producing images of the kidneys, ureters, and bladder.

• Indications:

  • Obstructive uropathy
  • Renal calculi
  • Tumors of the urinary system
  • Trauma to the urinary system
  • Infection of the urinary system

• Normal Radiological Findings on IVU:

  • The kidneys are outlined by a thin rim of contrast medium.
  • The ureters are narrow and tortuous, filled with contrast medium.
  • The bladder is filled with contrast medium, outlining its outline.

• Abnormal Findings:

  • Obstruction: The ureters are dilated, and the contrast medium is not excreted.
  • Hydronephrosis: The kidneys are enlarged, and the contrast medium is not excreted.
  • Calculi: The ureters or bladder contain stones, outlined by the contrast medium.

Homoeopathic Therapeutic Medicines:

• For Obstruction: Causticum and Lycopodium.
• For Hydronephrosis: Pulsatilla and Sepia.
• For Calculi: Calcarea carbonica and Ferrum phosphoricum.

Clinical Features of Obstruction:

• Acute pain in the abdomen or flank
• Nausea and vomiting
• Hematuria
• Urinary retention

Investigations for Obstruction:

• Urine analysis
• Blood tests
• IVU
• Ultrasound

Complications of Obstruction:

• Chronic kidney disease
• End-stage renal disease
• Peritonitis

Management of Obstruction:

• Medical treatment with diuretics and analgesics
• Surgical intervention to relieve the obstruction
• Urinary diversion procedures

Treatment of Obstruction:

• Conservative management with fluid replacement and analgesics
• Surgical intervention to relieve the obstruction
• Urinary diversion procedures

Bone Supply and Nerve Supply:

• The kidneys receive their blood supply from the renal arteries.
• The kidneys are innervated by the renal plexus.

Clinical Anatomy:

• The kidneys are located in the retroperitoneal space.
• The ureters are narrow and tortuous, passing from the kidneys to the bladder.
• The bladder is a muscular sac that stores urine.

Types of Obstruction:

• Extrarenal obstruction: Obstruction caused by external factors, such as tumors or stones.
• Intrinsic obstruction: Obstruction caused by a problem within the kidney, such as a tumor or scar tissue.

Causes of Obstruction:

• Renal calculi
• Tumors of the urinary system
• Trauma to the urinary system
• Infection of the urinary system

Clinical Features of Hydronephrosis:

• Abdominal pain
• Nausea and vomiting
• Hematuria
• Urinary retention

Investigations for Hydronephrosis:

• Ultrasound
• IVU
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)

Complications of Hydronephrosis:

• Chronic kidney disease
• End-stage renal disease
• Peritonitis

Management of Hydronephrosis:

• Medical treatment with diuretics and analgesics
• Surgical intervention to relieve the obstruction
• Urinary diversion procedures

Treatment of Hydronephrosis:

• Conservative management with fluid replacement and analgesics
• Surgical intervention to relieve the obstruction
• Urinary diversion procedures