IVP: Concerns About Radiation and Antibiotic Use in Urology

Q: IVP: Concerns About Radiation and Antibiotic Use in Urology

Hello： If you plan to have a child, it is best to avoid X-rays as much as possible; there is a possibility, but the chances are low. <br>After completing medication, you should return for a follow-up examination to check if the urine is normal.

Intravenous Pyelography (IVP)

Hello, doctor.
I have been experiencing recurrent bladder infections (approximately once a month, about six times).
The doctor has scheduled an intravenous pyelogram (IVP) examination, and I later found out that this requires at least five abdominal X-rays, which concerns me.
I am also undergoing assisted reproductive technology and fear that radiation may damage my oocytes.
The obstetrician-gynecologist advised minimizing exposure to X-rays.
Previously, my recurrent infections improved after taking antibiotics for about one day, so I often only take them for 1-3 days.
I suspect this may be the culprit.
I would like to ask:
1.
If the recurrent infections are solely due to not completing the full course of antibiotics, could this cause structural or functional damage to the urinary system? For example, conditions like urinary obstruction, vesicoureteral reflux, and chronic pyelonephritis (symptoms that would require IVP examination)?
2.
Besides extending the duration of antibiotic treatment (the last time the doctor advised me to take them for seven days), are there any further examinations or treatments needed due to the recurrent infections from not completing the antibiotic course?
After seeing the doctor, I realized I had many questions.
I kindly ask for your clarification.
Thank you!

WEN, 30~39 year old female. Ask Date: 2017/08/02

Dr. Du Shixi reply Urology

Hello: If you plan to have a child, it is best to avoid X-rays as much as possible; there is a possibility, but the chances are low.
After completing medication, you should return for a follow-up examination to check if the urine is normal.

Reply Date: 2017/08/02

More Info

When considering the implications of intravenous pyelography (IVP) in the context of recurrent bladder infections and the use of antibiotics, several important factors must be addressed.
Firstly, it is essential to understand the purpose of IVP. This imaging technique is primarily used to visualize the urinary tract, including the kidneys, ureters, and bladder, to identify any abnormalities such as stones, tumors, or structural issues. The concern regarding radiation exposure is valid, especially for individuals planning to conceive. An IVP typically involves several X-ray images, which can expose the patient to a cumulative dose of radiation. In comparison, a CT scan of the abdomen generally delivers a higher dose of radiation. However, the risk associated with radiation exposure, particularly at doses below 100 millisieverts, is considered low and unlikely to cause significant harm to reproductive cells. Nonetheless, it is advisable to consult with a healthcare provider to weigh the risks and benefits of undergoing such imaging, especially in the context of fertility treatments.

Regarding the use of antibiotics, it is crucial to adhere to the prescribed course. Incomplete antibiotic treatment can lead to persistent or recurrent infections, as the bacteria may not be fully eradicated. This can result in complications such as urinary tract obstruction, vesicoureteral reflux, or chronic pyelonephritis, which may necessitate further diagnostic imaging like IVP. If recurrent infections are indeed linked to incomplete antibiotic courses, it is vital to address this issue to prevent potential long-term damage to the urinary system.

To answer your specific questions:
1. Can incomplete antibiotic treatment cause structural or functional damage to the urinary system? Yes, recurrent infections due to inadequate antibiotic treatment can lead to complications such as urinary obstruction or chronic kidney infections. These conditions can potentially cause long-term damage if not addressed promptly. It is essential to complete the full course of antibiotics as prescribed to minimize the risk of recurrence and associated complications.

2. Is further examination or treatment necessary after incomplete antibiotic courses? If you have experienced recurrent infections, it may be prudent to undergo further evaluation. This could include additional imaging studies or urodynamic testing to assess bladder function and rule out anatomical abnormalities. Your healthcare provider may also consider a longer course of antibiotics or alternative treatments to ensure complete resolution of the infection.

In summary, while IVP is a valuable diagnostic tool for assessing urinary tract issues, the concerns regarding radiation exposure and the implications of antibiotic use should be carefully considered. It is crucial to maintain open communication with your healthcare providers, including both urologists and obstetricians, to ensure that all aspects of your health and future fertility are taken into account. Regular follow-ups and adherence to treatment plans are key to preventing complications and ensuring optimal health outcomes.

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