(b) The patient is allowed to breathe normally while the film in the
Potter-Bucky tray is quickly changed.
(c) The urologist withdraws the ureteral catheters and simultaneously
maintains pressure on the syringes to express the amount of contrast solution required
for maximum filling of the ureters.
(d) At a signal from the urologist, the ureterographic exposure is made.
The timing of the exposure is regulated so that the film will record the incidence of
maximum filling of the ureters. Exposure time should be as short as practical. Such
films are termed ureterograms.
(9) There are several variations of the above routine. For example, in some
instances, the kidney on one side is filled and the pyelographic film is exposed. Then
the same procedure is repeated for the kidney on the opposite side. The head of the
table is often elevated 35 to 45 for the ureterogram to demonstrate any kinking of the
ureters and to determine any downward displacement of the kidneys. On occasion, the
"split-exposure" technique may be used to differentiate between a ureteral calculus and
a calculus-like density superimposed with the density pattern cast by one or both of the
ureters. For this technique, the first exposure is made with the x-ray tube positioned as
for normal centering and the second exposure is made with the tube displaced laterally
1 1/2 to 3 inches. One half of the normal exposure time is used for the first exposure,
and two-thirds of the normal exposure time is used for the second exposure. Only the
tube is moved during this procedure, the position of the patient and the film remains
(10) In actual practice, the number and kind of films exposed depends upon
the patient's symptoms. The x-ray specialist should be prepared to take such views as
posterior-obliques, or laterals.
2-13. CYSTOGRAPHY AND PNEUMOCYSTOGRAPHY
a. General. Cystography is the radiographic study of the urinary bladder after
the introduction of a radiopaque contrast medium. The films thus obtained are
cystograms. When a radiolucent contrast medium (such as air) is used, the
examination is termed pneumocystography and the film is a pneumocystogram.
b. Patient Preparation and Scheduling.
(1) Unless specific orders are given, patient preparation and scheduling are
the same as for pyelography.
The patient is instructed to void before being placed on the x-ray table.