Idiopathic Hydronephrosis-The Diuresis Renogram: A New Non-Invasive Method of Assessing Equivocal Pelvioureteral Junction Obstruction

Abstract

A new method to evaluate patients with equivocal obstruction of the pelvioureteral junction is described. It involves the performance of a standard 131iodine-hippuran renogram followed by a second renogram 3 minutes after an intravenous injection of the diuretic, frusemide. When the 2 results are inspected together it is found that the patients can be separated into 4 groups: 1) normal, 2) obstructed, 3) atonic and 4) partially obstructed. The results in 23 children and 27 adults with suspected obstruction of the pelvioureteral junction are presented. Obstruction was confirmed in 18 patients and excluded in 32. The correlation between the renogram results and clinical, radiological and operative findings is discussed. The technique is simple, accurate and non-invasive, and it is recommended after excretory urography before proceeding to more invasive tests.

Simultaneous Measurement of Cystometry and Diuresis Renography during Full and Empty Bladder in Neurogenic Bladder Patients: A Preliminary Report

“…The diuresis renogram tended to show obstructive patterns with a full reservoir. Of several methods for measuring the degree of upper urinary tract obstruction, diuresis renography [4] and pressure-flow study [5] are the most popular, and diuresis renography is less invasive than a pressure-flow study. If we use a pres sure-flow study in this study, the results may be different, but it is almost impossible to perform a percutaneous nephrostomy in all patients.…”

“…In addition to these parameters, patterns o f the reno gram according to O'Reilly ct al. [4] (fig. 2), and split renal glomeru lar filtration rate (GFR) according to Gates [8] were calculated.…”

“…However, there have been a few reports on detailed investigations of upper urinary tract dynamics in comparison with lower urinary tract function [2,3], There are several methods for the analysis of the upper urinary tract, such as intravenous pyelography (IVP), ultrasonography, diuresis renography [4], pressureflow study [5], dynamic computed tomography [6], and …”

Correspondence

“…The authors write, referring to our own work, "Despite this, it is claimed that diuretic-enhanced "YmTc DTPA scanning is of particular value in just this group of patients" (O'Reilly et al, 1979). I fear this statement is grossly inaccurate and misleading.…”

Assessment of Hydroureteronephrosis by Renographic Evaluation under Diuretic Stimulus

“…The pattern of uptake and excretion of the radioindi cator and its variation, caused by the diuretic stimulus, allows differentiation of 5 different types of slopes [6,10,12,20], Type I: normal response, renogram with prompt up take and normal output of the radioindicator, within the period of normality.…”