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Antegrade Pyelography
Antegrade Pyelography
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Antegrade Pyelography
Category: Urinary system.
Subcategory: Structural tests.
Material studied: X-rays of kidney.
Estimated cost of test: $125.00 to $175.00.
Patient time for test: 1 to 1-1/2 hours.
Reliability of test results: Good. Other tests, studies and clinical observations are necessary to establish a precise diagnosis.
Available as home self-test? No.
Note: Test is used when obstruction prohibits retrograde studies.
BEFORE THE TEST
Purpose of test:
Evaluates obstruction of the upper collecting system of the kidney.
Evaluates kidney disease revealed in previous tests.
Aids placement of nephrostomy tube*.
Evaluates function of the upper collecting system of the kidney after surgery.
Assesses kidney function before surgery.
Where is test performed?
Hospital, doctor's office, outpatient or free standing surgical facility.
Who performs test?
Doctor.
Risks and precautions:
This test is hazardous if you have a bleeding disorder.
Tell your doctor if you have any reaction to shellfish, iodine or dye used in other diagnostic tests.
Patient preparation:
Activity--No changes necessary.
Diet--Don't eat for 4 hours before test. Continue drinking fluids.
Medicines--Inform the person performing the test if you have recently taken any medications listed under Taking these drugs may affect test results. You may be asked not to take this medication before the test.
Disrobing--Remove all clothing. Put on surgical gown.
THE TEST
Sensory factors:
Touching--You will experience temporary, minor pain for a short period when local anesthetic is injected. You may be uncomfortable for 35 to 45 minutes when you assume the positions the technician requests. You must be absolutely still while the scanning takes place, or the test may need to be repeated. Hands held above head and feet frequently become numb during the examination. Examining rooms frequently become uncomfortably cool when you disrobe for the examination. Ask for a blanket if you are cold. You may experience pressure in your stomach as the endoscope is moved about and a feeling of fullness when air or carbon dioxide is blown in.
Seeing--You will see the technician, nurse or doctor, the basket or tray to hold the equipment, the needles, syringes, collecting tubes and bandages.
Tasting--Not affected.
Hearing--You will hear sounds of surgical operating-room equipment and instruments.
Smelling--You will smell the strange odor of anesthetic and antiseptic chemicals.
Feeling--You may feel intimidated by the people and surroundings. Some degree of apprehension or fear is normal and should be expected. This discomfort disappears when the test is completed. You may also feel uncomfortable for a short while if small, enclosed space causes you discomfort.
Equipment used:
X-ray table and X-ray machine.
Fluoroscope.
Antiseptic solution.
Local anesthetic.
Sterile needles and sterile syringes.
Dye.
Sterile specimen containers.
Manometer.
Percutaneous* nephrostomy instruments.
Emergency resuscitation equipment.
Description of test:
You or a close relative will be required to sign a consent form after the procedure has been explained to you.
Skin is cleaned with antiseptic.
Local anesthetic is injected in kidney area.
The procedure does not begin until you are numb.
Flexible tubing with a manometer is attached to a special needle.
Using the fluoroscope as a guide, needle is inserted into the kidney.
Pressure readings are recorded.
Dye is injected into the kidney.
You may feel a brief burning and flushing.
X-rays are made of kidney's upper- collecting system.
Urine may be collected from the kidney for testing. In some cases, a tube is left in the kidney for drainage.
Urine is sent to the laboratory for analysis.
AFTER THE TEST
Immediate post-test care:
Recovering from a local anesthetic, your vital signs are checked and pain medication provided, if needed.
Your fluid intake and urinary output are monitored for 24 hours.
Urine is examined to see if you are passing blood.
After you have urinated three times, if blood still appears, notify your doctor.
Notify your doctor if you haven't urinated 8 hours after the procedure.
Activity after test:
Report any signs of infection to your doctor, such as chills, fever, rapid pulse, rapid respiration or a feeling of faintness.
Resume normal diet.
Return to pretest activities as soon as you are able.
Time before test results available:
Time before results are reported to the doctor or patient varies from a few minutes to a few days.
TEST RESULTS
Test values:
Test results are determined by studying X-rays.
Normal values:
No anatomical or functional abnormalities.
Pressure below 20cm of water.
What ABNORMAL may indicate:
Hydronephrosis*.
Intrarenal pressures that exceed 20cm/water indicate obstruction.
Malignancy*.
Pyelonephrosis*.
Taking these drugs may affect test results:
Anti-coagulants.
Other factors that may affect test results: Failure to follow dietary restrictions.
*See Glossary.
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From Complete Guide to Medical Tests by H. Winter Griffith, M.D. Copyright by Fisher Books. Electronic rights by Medical Data Exchange.
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