Investigations

If we need further information to help diagnose or treat your condition, we will let you know. In almost all circumstances, we will want to review the results of your tests with you. Unless alternative arrangements have been made, please contact us to arrange a follow-up appointment unless one has already been booked for you.

 

Laboratory Testing

Most lab testing can be performed at any of the public or hospital laboratories. The generic requisition we print for you will be accepted at any of these labs. No matter which lab you go to, the quality of testing is the same. Almost all laboratory testing is covered by the public health plan. We will let you know if additional charges are anticipated.

Timing of Tests and Preparation

Please complete your tests as soon as possible after your receive the requisition unless we request that you do it at a later date. Most test results are available within a few days of doing the test but some types of tests take much longer. It is important you go for the test as soon as possible to avoid unnecessary delays in your treatment. Some tests which take longer to obtain results include:

  1. Karyotype and Y-chromosome microdeletion tests for infertility: up to 3 months

  2. Stone analysis: 2-3 weeks

  3. Urine cytology: 2-3 weeks

  4. 24 hour urine collections: up to 3 weeks

  5. Biopsy or surgery pathology results: 3 weeks

Preparation for Laboratory Tests

Most of the lab tests we order require absolutely no preparation (e.g. fasting). On the occassions where specific preparation is required, we will let you know. You can also check on the Lab Web sites and the Conditions and Health Topics section of our site for more information on your condition and some of the tests we do for diagnosis and treatment. Tests which do require special preparation include: 

  1. Semen analysis: these are only accepted at specific times and locations as listed after the link

  2. Testosterone: within 3 hours of waking unless you are on testosterone supplementation in which case the blood test should be drawn (a) 1 week after your last injection if you are on intramuscular testosterone (e.g. Depo T) or (b) in the morning if you are using sking gel (e.g. Androgel or Testim)

  3. Urine cytology: avoid using the first sample of the day or after fasting

Your requisition will be accepted at any laboratory including BC Biomed, Life Labs and the hospital labs. Please note that there are a few lab tests (e.g. semen analysis) which are only accepted at specific sites and at specific times. Please refer to the websites for up to date information

Hospitals: unless we specifically request that you have a lab test done at a hospital, please have the test done at your local BC Biomed or Life Labs. Most hospital laboratory testing is restricted to inpatients or prior to upcoming surgery.

Dr. Sai Ma's Research Laboratory: Dr. Ma performs specialized genetic testing for male infertility. Her lab is located at BC Women's Hospital & Health Centre

Room D414B

Tel: 604-875-2000 ext. 5686   Fax: 604-875-2722 

Imaging

Imaging tests include things such as X-rays, ultrasounds, CT scans, MRI, and nuclear medicine scans. We will take care of sending the requisition to the imaging centre. Following this, the imaging centre will contact you, schedule a time for your test and give you instructions if preparation is necessary. We do not have any control over when the imaging labs schedule your test. If you have concerns regarding wait times, we recommend that you contact the imaging centre first before contacting us.

Specific Test Preparation for Imaging Tests

We have included info on some of the most commonly performed tests which require preparation. Please be aware that this is not a comprehensive list and the preparation may not apply to your specific circumstances.

Preparation for CT scans WITH CONTRAST

You will require a blood test (Creatinine) to ensure that your kidney function is satisfactory before undergoing the scan. If you have impaired renal function, you may be asked to take acetylcysteine prior to your test. If you are on METFORMIN, you will be given specific instructions by Radiology on when to stop and resume this medication.

Preparation for Kidney Biopsy

Biopsies of the kidney take core samples using a needle. While the risk of bleeding is low, there is always some risk. Testing you ability to clot and discontinuation of medications which inhibit clotting may be necessary.

1. Lab testing: INR/PTT and CBC within 1 month of the procedure. If Coumadin/warfarin is used, an additional INR/PTT is required within 24 hours prior to the test

2. Antiplatelets and anticoagulants.

  1. Stopping: Low dose aspirin (ASA) 81 mg may need to be stopped. For everything else, the requirements vary depending on the test and medication and between 2-7 days off the medication will be required.

  2. Restarting: generally 2 days after procedure is safe for all medications

  3. Bridging: in some cases, use of an injection of 'low molecular weight heparin' (LMWH) is required to reduce the risk of clotting until just before the procedure. Your physician will let you know when and how to use. In all cases, the LMWH is NOT to be taken the day of procedure.

Vancouver Coastal Health and Fraser Health Authority Guidelines for Discontinuation of Medications Prior to Radiologic Interventions (2015)

Imaging Contact

Brooke Radiology Associates: Outpatient radiology centers in Richmond and Burnaby. The same radiologists that review films and do procedures in Richmond Hospital, Burnaby Hospital and Delta Hospital constitute the Brooke group.

Greig Associates Radiology: Outpatient radiology centers in Vancouver

You can find information on Hospital locations on our Contact Page 

Radiation Exposure in X-ray and CT Examinations

We are commonly asked about safety and radiation exposure by patients undergoing tests. The American College of Radiology and the Radiological Society of North America have information on radiation exposure and the associated risks. We do not order unncessary tests and attempt to balance the benefits and potential harms of the tests we order. It is important to consider the potential harms from imaging studies in the context of the the background exposure to radiation from the environment and the overall risks of cancer. Please contact us if you have any questions or concerns.

Note that a CT KUB has a radiation dose similar to an IVP - about 1.5-3 mSv

Radiation doses for Common Radiologic Procedures and Estimaged Lifetime Risks

American College of Radiology and Radiological Society of North America Patient info on imaging safety

Review of Risks of Iodine Based Contrast Exposure on Kidney Function: Article 1 Article 2

Contrast Reaction Prophylaxis

Some types of imaging such as contrast CT or interventional procedures requiring embolization (of kidney or gonadal veins) utilize intravenous contrast. Contrast is composed of molecules containing iodine which can be seen with X-ray/CT. Some patients may be sensitive or allergic to these agents. Of note, many types of allergies are not true anaphylaxis reactions. Anaphylactic reactions generally preclude the use of contrast and alternative methods of investigation will be required.

In cases where a mild or moderate contrast allergy exists, pre-treatment with a medication can prevent such a reaction. Based on Fraser Health guidelines (Rev February 18, 2021), options include the following:

  1. A corticosteroid

    1. PredniSONE 50 mg by mouth 11-13 hours prior to the procedure, then 7 hours prior to the procedure, then 1 hour prior to the procedure. OR

    2. Methyprednisolone 40 mg intravenous 12 hours prior to procedure and at 2 hours prior to procedure

  2. An antihistamine

    1. Diphenhydramine 50 mg po 1 hour by mouth prior to procedure OR

    2. Diphenhydramine 50 mg iv 1 hour prior to procedure

Other Types of Investigations

Test to evaluate the anatomy of the lower urinary tract. Sometimes used for minor procedures.

 

Test which measures the function of the lower urinary tract - the bladder and the outlet. It is sometimes combined with X-ray imaging (video urodynamics)

 

For males and females who

  1. Need to urinate frequently

  2. Have urinary incontinence (leakage)

  3. Wake up at night often to urinate (nocturia)