Definition of Retrograde Urogram**
A retrograde urogram, also known as a retrograde pyelogram or intravenous urogram (IVU), is a radiographic examination of the urinary tract using a contrast agent injected through the urethra into the bladder.
Indications of Retrograde Urogram
- Obstruction of the ureter or renal pelvis
- Calculi (stones) in the ureter or renal pelvis
- Trauma to the urinary tract
- Tumor or cyst in the urinary tract
- Abnormalities in the urinary tract
Technique of Retrograde Ureteropyelography
1 → Insertion of a cystoscope into the urethra → Insertion of a catheter into the urethra → Injection of a contrast agent into the urethra → X-ray examination of the urinary tract
Normal Findings on Retrograde Urogram
- Normal shape and size of the renal pelvis and calyces
- Normal position of the ureters
- No obstruction or dilatation of the urinary tract
Abnormal Findings on Retrograde Urogram
- Obstruction of the ureter or renal pelvis
- Dilatation of the urinary tract
- Calculi (stones) in the ureter or renal pelvis
- Tumor or cyst in the urinary tract
- Abnormalities in the shape or size of the renal pelvis or calyces
Pathology
- Ureteral obstruction: blockage of the ureter by a stone, tumor, or other mass
- Ureteral stricture: narrowing of the ureter by scar tissue
- Ureteral fistula: abnormal connection between the ureter and another organ or structure
- Renal obstruction: blockage of the renal pelvis or calyces by a stone, tumor, or other mass
Clinical Features
- Pain in the flank or lower back
- Frequency or urgency of urination
- Hematuria (blood in the urine)
- Fever or chills
- Nausea or vomiting
Investigations
- Retrograde urogram
- Intravenous urogram (IVU)
- Computed tomography (CT) scan
- Ultrasound examination
Complications
- Urinary tract infection (UTI)
- Pyelonephritis (infection of the kidney)
- Perforation of the urethra or bladder
- Hemorrhage (bleeding) from the urethra or bladder
Management and Treatment
- Conservative management: bed rest, fluids, and antibiotics
- Surgical management: removal of the blockage or mass
- Endoscopic management: insertion of a stent to open the blocked ureter
- Nephrostomy: insertion of a catheter into the kidney to drain urine
Homoeopathic Therapeutic Medicines
- Aconitum napellus: for pain and inflammation
- Arnica montana: for trauma and bleeding
- Belladonna: for inflammation and pain
- Chamomilla: for anxiety and restlessness
- Colchicum autumnale: for gout and arthritis
- Conium maculatum: for paralysis and weakness
- Lachesis: for fever and inflammation
- Lycopodium clavatum: for kidney and urinary tract problems
- Pulsatilla: for mood swings and emotional changes
- Rhus toxicodendron: for skin problems and allergies
- Sepia: for hormonal imbalances and mood swings
- Silicea: for skin problems and inflammation
- Uva ursi: for urinary tract infections
Blood Supply
- Renal artery: supplies blood to the kidney
- Ureteral arteries: supplies blood to the ureter
- Bladder arteries: supplies blood to the bladder
Nerve Supply
- Renal plexus: supplies nerves to the kidney
- Ureteral plexus: supplies nerves to the ureter
- Bladder plexus: supplies nerves to the bladder
Clinical Anatomy
- Kidney: filters waste and excess fluids from the blood
- Ureter: carries urine from the kidney to the bladder
- Bladder: stores urine until it is excreted
- Urethra: carries urine from the bladder to the outside of the body