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Introduction:Though widely performed, the safety of retrograde uropyelography in patients with documented intravenous, iodinated contrast allergy (“contrast-allergy”) is unclear. We performed a retrospective review of a single institution’s experience with patients with contrast-allergy undergoing uropyelography.
Materials & Methods:Patients undergoing retrograde uropyelography at a single institution were identified between 2011-2014. Acute allergic reactions (AAR) were searched by ICD codes for “acute respiratory failure”(518.81,518.84), “anaphylaxis”(995.0), and “drug reaction”(995.27). The date of the ICD-9 occurrence was compared to the index surgery date. Charts of those with contrast-allergy and these ICD-9 codes were manually reviewed to elucidate whether an AAR actually occurred within 24 hours of surgery.
Results:A total of 2,650 patients were evaluated, 1325 female (50%). Of these patients, 113 (4.2%) had contrast-allergy. Potential AAR related ICD-9 codes at any time were identified in 21 patients with contrast-allergy: 10 (0.3%) with respiratory failure (518.81, 518.84), 11 (0.04%) with anaphylaxis (995.0), and 0 with drug reactions (995.27). Only one patient (0.9%) with contrast-allergy was found to have an event within 24h postoperatively: AAR-related ICD-9 code of “acute respiratory failure,” but found to be an unrelated myocardial infarction.
Conclusions: In this series of 113 patients with history of contrast allergy undergoing intraureteral contrast administration, none suffered perioperative drug reaction or anaphylaxis. These findings reflect conventional practice and moreover may help alleviate commonly voiced preoperative concerns.