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An antegrade pyelogram is an imaging test to find a blockage (obstruction) in the upper urinary tract. Your urinary tract includes the kidneys, ureters, and bladder. The ureters are the narrow tubes that carry urine from the kidneys to the bladder.
During the test, the radiologist injects a contrast dye into a kidney. The radiologist uses X-ray images to watch the contrast dye as it moves from the kidney into the ureter and then to the bladder.
X-rays use a small amount of radiation to create images of your bones and internal organs. X-rays are most often used to detect bone or joint problems, or to check the heart and lungs. An antegrade pyelogram is one type of X-ray.
Fluoroscopy may also be used during this test. It is like an X-ray "movie." Or the radiologist may use ultrasound. These tests can help the doctor locate the kidneys and ureters.
You may need an antegrade pyelogram if other imaging tests did not give your doctor enough information to make a diagnosis. You may have had a retrograde pyelogram, a similar test that looks at the kidneys and ureters. Or you may have had an intravenous pyelogram. In that test, the contrast dye was injected into a vein instead of into your kidney or ureter.
The antegrade pyelogram can find a blockage in the urinary tract caused by:
The radiologist can find the blockage by looking at the X-ray images. The contrast dye will not be able to move through the kidney if you have a blockage.
You may also need this test to assess the kidneys or ureters before or after surgery. If you have a blockage, the surgeon may use a special tube (nephrostomy tube) to pass the urine around the blockage.
Your health care provider may have other reasons to recommend an antegrade pyelogram.
You may want to ask your health care provider about the amount of radiation used during the test. Also ask about the risks as they apply to you.
Consider writing down all X-rays you get, including past scans and X-rays for other health reasons. Show this list to your provider. The risks of radiation exposure may be tied to the number of X-rays you have and the X-ray treatments you have over time.
Tell your health care provider if you:
Possible complications of antegrade pyelogram include:
You may not be able to have this test if you have a blood clotting disorder.
You may have other risks depending on your specific health condition. Be sure to talk with your provider about any concerns you have before the procedure.
You may have an antegrade pyelogram as an outpatient or as part of your stay in a hospital. The way the test is done may vary depending on your condition and your health care provider's practices.
Generally, an antegrade pyelogram follows this process:
After the procedure, you will be taken to the recovery room. Medical staff will watch your blood pressure, pulse, and breathing. Once you are alert, you will be taken to your hospital room or sent home.
Your urine will be watched closely to see how much of it you are making and if you have any blood in it. Your urine may be red from even a small amount of blood. This is considered normal. You may be told to keeping looking at your urine output for a day or so once you are home.
You may have pain when you urinate. Take a pain reliever for soreness as recommended by your health care provider. Take only the medicines your provider tells you to. Aspirin or certain other pain medicines may raise the risk of bleeding.
Call your health care provider right away if any of these occur:
Your health care provider may give you other instructions, depending on your situation.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.