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Urology/IVP/Retrograde Pyelogram


Dr. Leslie:
What is the difference between a IVP and Retrograde Pyelogram?
Do they both evaluate the same things? I heard the Pyelogram is used if the patient is allergic to Iodine, but also heard it is used if the IVP does not show any abnormalities.Which is least invasive for a male patient?

IVP stands for intravenous pyelogram and is a series of x-rays given after IV contrast.  For better clarity and definition and in highly allergic patients, we use retrograde studies.  This requires anesthesia and the placement of a cystoscope into the bladder.  We then locate the open end of the ureter, place a small tube into it, and inject contrast.  The contrast goes up towards the kidney as we take an x-ray picture.  While this is a superior picture, it is far more invasive than the IVP.  It's called a retrograde because the contrast is injected into the lower end of the ureter and goes opposite to the normal flow of urine which is from the kidneys towards the bladder.  In a retrograde study, the contrast goes from the bladder towards the kidneys.  This is often used during urological surgery.

The choice of x-ray depends on the specific circumstances of the patient and the problem that is being investigated.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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