These include the intravenous pyelogram, cystoscopy and urodynamic studies.
Intravenous pyelogram
This X-ray technique (known also as IVP) is used to detect cysts, stones, congenital abnormalities and other abnormalities of the kidneys, ureters and bladder. A radio-opaque dye is injected into a vein in the arm, from where it travels in the blood to the kidneys and outlines their shape as they filter the dye from the blood. X-rays are taken at various stages during the filtering process. As the dye passes into urine, the shape of the ureters is outlined as urine flows from kidneys to bladder. The final film is taken after emptying the bladder. The procedure takes about half an hour.
Cystoscopy
A slender tube that acts like a wide-angle telescope is passed through the urethra into the bladder so that the interior of the bladder can be inspected. General anaesthetic is usually used for cystoscopy, which can detect bladder stones as well as inflammation, tumours and other disorders of the bladder lining. Stones and small benign tumours may be removed and bladder lining biopsies taken, and soma inflammatory bladder conditions can
be treated by diathermy through the cystoscope.
Urodynamic studies
These measure the pressure within the bladder and urethra during filling and emptying of the bladder, and how this is affected under the stress of increased intra-abdominal pressure. Slender catheters attached to external pressure gauges are inserted into the bladder and urethra. Combining pressure measurements with contrast X-rays of the interior of the bladder and urethra (by intravenous pyelogram) allows precise diagnosis of the cause of incontinence or other problems with passing urine.
Ultrasound is often used to create images of the kidneys, ureters and bladder. It is particularly useful when urinary function needs to be investigated during pregnancy and X-rays might be harmful to the foetus.
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