Retrograde Pyelogram

A Retrograde Pyelogram (RPG) is a specialized type of imaging that is performed to visualize the urinary collecting system (i.e. ureters and renal pelvis) the other imaging studies (such as ultrasound or IV contrast CT scans) have been inconclusive or cannot be done.

Purpose of Retrograde Pyelogram

• To identify obstructions, stones, tumor, strictures or congenital abnormalities of the urinary tract.
• The contrast is often used in situations where intravenous contrast cannot be administered thanks to allergy or kidney issues.
• Have the ability to direct some urological surgeries, such as stenting.

Advantages

• Applicable in patients who are unable to get IV contrast.
• Delivers good visualization of ureters and renal pelvis.
• May be used together with treatment techniques such as stone removal.

Retrograde Pyelogram Test

The Retrograde Pyelogram Test is an x-ray test that is used to identify the ureters (pathways between the kidneys and the bladder) as well as the renal pelvis (the urine collecting part of the kidney) by introducing contrast dye directly into the ureters through the bladder. Contrast is typically injected retrograde (backward) into the ureter (RPG) as compared to the intravenous pyelogram (IVP), in which the contrast is injected into a vein.

How the Test is performed?

Patient Preparation:

• Typically performed as local or regional or general anaesthesia.
• Patient might have to void the bladder prior to the procedure.

Catheter Placement:

• A thin tube with a camera known as a cystoscope is passed through the urethra and inside the bladder.
• Then a catheter is inserted in the ureter.

Contrast Injection:

• The ureter is injected with contrast dye.
• The dye travels up to the kidney where it is taken as an X-ray or fluoroscopy.

Image Interpretation:

• The images reveal any obstructives, rocks, tumors, or abnormalities of the structure.

Retrograde Pyelogram Indications

The Retrograde Pyelogram (RPG) is an advanced imaging device that is applied to visualize the ureters and the renal pelvis. Mostly it is denoted in cases where other imaging examinations might be inconclusive or not possible.

The following is a list of indications in detail:

Possible Ureteral Obstruction

• Obstructed ureter by kidney stones.
• Ureteral strictures or constriction.
• Tumor or extrinsic compression.

Hematuria (Blood in Urine)

• To determine the etiology of bleeding in ureters or renal pelvis.
• To identify tumors in the ureter or the renal pelvis.

Analysis of Urinary Tract Abnormalities

• Congenital defects e.g. duplicated ureters or ectopic ureters.
• Abnormalities of the ureters or the renal pelvis that are not visible using ultrasound or CT.

Pre-Surgical Planning

To evaluate the anatomy of the ureters prior to surgery including:

• Ureteral stent placement
• Stone removal surgery
• Tumor resection

Intravenous Contrast is not applicable

Patients with:

• Allergy to IV contrast
• Renal dysfunction (toxic IV contrast is not permitted because of renal dysfunction)

Postoperative Urological Surgery

To check for:

• Postoperative strictures
• Poststent or postreconstruction urinary (ureteral) patency.

Diagnosis of Masses or tumors

• To identify tumours of the ureteral or renal pelvis in cases where other imaging is not conclusive.

Retrograde Pyelogram Recovery

The post procedure recovery following Retrograde Pyelogram (RPG) is normally not difficult since this is a procedure that is minimally invasive. Here’s a detailed overview:

Immediate Post-Procedure

• Patients are normally observed near the test timeframes and then sent home.
• A few mild pain or burning on urination is typical.
• A small quantity of blood in the urine (hematuria) can be observed during 1-2 days.

Pain and Discomfort

• Also, mild lower abdominal or flank pain can happen when catheterized or contrast injected.
• The pain can normally be addressed using over-the-counter pain relievers.
• A physician should be contacted on persistent or acute pain.

Activity

• Majority of the patients are able to resume their normal activities within the same day.
• During 24 hours, one should avoid active work or heavy lifting to avoid irritation.

Urination

• Heightened frequency or urgency can be provisional.
• Consuming a lot of water aids in the flushing out of contrast dye to lessen irritation.
• Seek medical attention when the burning condition becomes more severe or when the blood in the urine continues more than two or three days.

Factors Affecting Retrograde Pyelogram Cost

The price of a Retrograde Pyelogram (RPG) is subject to a wide range of influences by its numerous factors. The following is a breakdown of what causes the price:

Hospital or Clinic

• Facility type: Private hospitals tend to be more expensive than government or public hospitals.
• Popularity and location: Well known or those located in the metro cities incur high prices.

Expertise of the Urologist

• Very experienced urologists or experts might be charging more when consulting and performing procedures.
• The presence of a trained radiologist to interpret the images may also impact the cost.

Type of Anaesthesia

• Local anaesthesia is cheaper.
• General or regional anaesthesia will be more expensive because of the cost of anaesthesia, observation, and aftercare.

Imaging Technology

• The prices differ according to the machine used in x-ray or fluoroscopy.
• Modern imaging systems can be of a higher quality but are more expensive.

Complexity of the Procedure

• Basic diagnostic is cheaper.
• The cost increases in case further procedures are carried out at the time of carrying out the test (e.g. stent placement, stone removal).

Pre- and Post-Procedure Care

• Blood tests, urine tests or pre-anaesthesia check-up costs.
• Charges in recovery rooms and post-procedure care can be expenses on top of cost.

Medications

• The overall cost can be affected by contrast dye, painkillers and antibiotics (assuming that they are administered).

Geographic Location

• The expenses are usually more in the city than in smaller towns or regions.

Best Hospital for Retrograde Pyelogram

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Conclusion

A Retrograde Pyelogram (RPG) is a diagnostic imaging process, safe and effective, which is used to visualize the ureters and the renal pelvis. It is also useful specifically in identifying obstructions, stones, stricture, tumour, or knowingly abnormal development of the urinary tract in case of intravenous contrast. This is done by placing a catheter in the bladder and injecting contrast dye in reverse (retrograde) where the dye is passed in the ureters to provide X-ray images. The recovery is usually fast and most patients start their normal functioning within the same day though slight urinary discomfort and occasional hematuria may be experienced. RPG prices depend on the type of hospital, experience of the doctor, anaesthesia, imaging technology and other processes. All in all, RPG is an important instrument in urology diagnosis and treatment and offers in-depth imaging that can inform the decision-making process of the treatment.

Why Choose GetWellGo for Retrograde Pyelogram Treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for Retrograde Pyelogram treatment.
• Expert urologists with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food

FAQ

Is the procedure painful?

• It may have mild discomfort, burning, or cramping. The pain is minimized by local or general anaesthesia.

What is the period of the procedure?

• Typically, 30-60, which varies with the complexity

How long is recovery?

• The majority of patients are cured and do not have to spend any additional time; they can restart their usual lives. Light burning or blood in urine can take 1-2 days.

Do I need to prepare for the test?

• Urinate before the surgery.
• Take any fasting or medicine as prescribed by your physician.