Patient Bilateral Retrograde Pyelograms in The Office

1. You have been recently found to have blood in the urine and the two procedures recommended by the American Urological Association are CT Urogram [a Cat Scan of your Abdomen and Pelvis with and without dye] and preferably a cystoscopy with dye being shot up to your kidneys in our urodynamics chair.
    

2. You will be brought to our urodynamics room and placed in the chair.  Your vagina and urethra will be prepped with betadine and your urethra numbed with lidocaine.  A Valium 10 mg suppository will be placed, and you will also receive a shot of Toradol for pain.  We will wait 20-30 minutes while checking on your every few free moments.  Once we decided you are very relaxed we {Myself, Amy and Paula] will enter the room with our x-ray gowns on.  We will have the thin part of the x-ray machine at the level of your abdomen and you will be sterily draped.
    

3. I will slowly talk to you during this procedure letting you know what we are getting ready to do and what you will be experiencing.
    

4. I will be placing a cystoscope into your urethra and we will be advancing a catheter up your right and left kidney and shoot 10 mls of dye with fluoroscopy x-ray briefly on. You will be able to look over your left shoulder and see the pictures we will be taking, and I will explain to you during and afterwards any problems we might see with the x-rays for your diagnosis. The typical procedure time is 3-5 minutes.
    

5. Afterwards, you may experience some blood in your urine and Amy will be giving you the following prescriptions usually before your surgery date.  A. Levaquin 750 mg, once daily, #10 to help prevent urinary tract infections. B. Norco 10 mg #60, one to two every 4-6 hours for pain.  Pyridium 200 mg QID #20 for burning with urination.
    

6. A urine cytology will also be collected and if abnormal you will be notified by our staff.  A urine cytology is the examination of urine under a microscope to look for cancer cells. A positive screening may indicate that you have a cancer somewhere in your urinary tract and you may need further frequent evaluations.
    

7. All CT Urograms will be performed prior to your cystoscopy with retrogrades so we can complete your workup for blood in the urine with this single procedure.
    

8. We encourage all patients to ask questions during your study and we will be happy to outline your anatomy for you.
    

9. If both your Ct Urogram, Cystoscopy with retrogrades and urine cytology are found to be normal you have successfully completed your blood in the urine work-up and all you will need is a repeat urine cytology in one year.
    

10. In the months after your study you may remain positive for blood in the urine but a change from microscopic hematuria to gross hematuria or blood in the urine that can be seen withyour eyes please call us to see if there is anything else to be concerned about.
     

11. Thank you for your time reading and implementation of our cystoscopy with retrograde pyelograms aftercare instructions.