A loopography is a specialized, live X-ray scan (fluoroscopy) used to check an artificial urinary channel, known as an ileal conduit or "urolink." This channel is surgically created using a small loop of bowel to drain urine out of the body through an opening (stoma) on the abdomen, typically after the bladder has been removed due to cancer.
During the scan, a small catheter is gently inserted into the stoma opening, and a liquid dye (contrast) is injected. X-ray images are taken as the dye fills the conduit and flows back toward the ureters and kidneys.
Common Indications for a Loopography
- Checking for narrowing (strictures) or blockages in the surgically created conduit or ureters.
- Investigating suspected urine leaks or abnormal connections (fistulas).
- Evaluating recurrent urinary tract infections or declining kidney function.
- Screening for stones or tumors in the conduit or kidneys.
- Assessing the conduit's shape and size during routine follow-ups.
What exactly does a loopography show?
The scan shows the size, shape, and draining capacity of the ileal conduit. It also shows the ureters and the kidneys, highlighting any narrow areas, blockages, leaks, or kidney swelling (hydronephrosis).
How should I prepare for a loopography?
No fasting is required. You can eat and drink normally. You should bring a spare stoma bag and any stoma care supplies you normally use, as you will need to remove your current bag for the scan and apply a new one afterward.
Do I need to stop taking medication?
No. Continue taking all your medications as normal. Inform the scan team if you have any allergies to contrast dye or iodine.
What happens when I arrive for my scan?
You will go to the fluoroscopy room. The radiographer will ask you to lie flat on your back on the X-ray table and expose your abdomen. They will help you remove your stoma pouch and gently clean the skin around the stoma.
How is the procedure performed?
The doctor will gently slide a small, soft catheter into the stoma opening. They will slowly inject the contrast dye through the catheter. You may feel a cooling or stretching sensation. The radiographer will take X-ray images at regular intervals. Once completed, the doctor will drain the dye out through the catheter, remove the tube, and clean your skin. You can then apply your new stoma bag.
How long does a loopography take?
The procedure takes about 20 to 30 minutes. Most of this time is spent cleaning the stoma area and positioning you.
Is there any discomfort?
You will feel some mild pressure or fullness in your abdomen as the contrast dye is injected. While this can feel unusual, it is generally not painful. Let the team know if you feel any sharp pain.
Are there risks?
Yes, but they are very small. The main risk is a urinary tract infection. There is a very small risk of an allergic reaction to the contrast dye or a minor injury to the stoma tissue. The scan uses a low dose of radiation, similar to a few months of natural background radiation.
Can children have this scan?
Yes. Children who have undergone urinary diversion surgery can have this scan safely.
Can I have this scan if I am pregnant?
Pregnancy Precaution
Tell your doctor or radiographer if you are pregnant or think you might be. Because this scan uses X-rays directly over the pelvis and abdomen, it is avoided during pregnancy unless absolutely essential to treat a severe kidney issue.
When will I get my results?
A radiologist will study the images. A report will be sent to your referring doctor or handed to you within 24 hours.
What if the scan finds something?
If the scan identifies a narrowing, leak, or blockage, your referring surgeon or urologist will discuss management options, which may include a procedure to stretch the narrow area, placing a stent, or surgical revision.
Conclusion
A loopography is a safe and detailed way to monitor the health of your reconstructed urinary system. To ensure a comfortable appointment, remember to bring your stoma care kit and a spare pouch to the clinic.