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PubMed1980

The role of anterograde pyelography in the transplant kidney.

Ureteral obstruction or sloughing must be considered as a cause of non-function or poor function of the transplanted kidney. Established investigative techniques may not exclude a ureteral lesion conclusively or define its exact site if present. The role of anterograde pyelography in this situation is discussed. It is concluded that anterograde pyelography is a simple, safe and valuable investigation of the outflow tract of the transplanted kidney.

Humans↗

PubMed1979

An evaluation of discrepancy in capacity and contour of the neurogenic bladder as shown on cystography and pyelography.

A significant difference in the filling of the bladder with contrast medium on intravenous pyelography as compared to cystography has been noted in patients with spinal cord injury. Bladder capacity and contour of the bladder wall have been assessed in 50 patients with impaired bladder innervation consequent upon spinal cord injury. In 32% of the patients the bladder capacity was significantly greater when measured on pyelography than that found in cystography. The causes for this discrepancy in bladder filling on the two examinations are discussed. The possibility of erroneous assessment of the capacity and contour of the neurogenic bladder on cystography is pointed out.

Female↗

PubMed1980

Value of combined intravenous renal arteriography and pyelography in the diagnosis of renovascular hypertension.

1. The technique of combined intravenous renal arteriography and pyelography is described and results in 848 hypertensive patients are reported. 2. The procedure was tolerated better than Seldinger arteriography and the diagnostic accuracy for renal artery stenosis was 95%. 3. The prevalence of renovascular disease was 7%. 4. Cost-effectiveness calculations favour combined intravenous arteriography and pyelography rather than the usual approach based on assessment of the indications for Seldinger arteriography from clinical and urographic signs.

Cost-Benefit Analysis↗

PubMed1992

[The imaging diagnosis of acute renal transplant obstruction with special reference to antegrade pyelography].

30 patients with an acute build-up of renal transplant were examined comparatively via antegrade pyelography (AP), computed tomography (CT) and sonography (SONO). In the proof of obstructions and compressions of the ureter of renal transplant, antegrade pyelography was superior to sonography and computed tomography. Perirenal collections of fluids were recognised correctly via sonography by 73% (11/15) and computed tomography by 87% (13/15). The computer tomogram is superior in the differentiation of perirenal collection of fluids. In establishing proof of the cause of an acute build-up of renal transplant it was evident that computed tomography with a sensitivity of 64% and a specificity of 94% was slightly superior.

Acute Disease↗

PubMed1983

[Comparative studies of renosonography and intravenous pyelography prior to and following hysterectomy].

Prior to hysterectomy investigation of the upper urinary tract and documentation of the investigation is important for treatment and liability reasons. The X-ray exposure possible allergy to the dye and the high price of intravenous pyelography mitigates against the investigation. This prospective study of 155 patients with benign disease shows that sonography is a valuable screening procedure. In over 90% of the cases sonography was sufficient and in only 11 women additional intravenous pyelography was necessary. The incidental discovery of an assymptomatic carcinoma of the kidney and of a hydronephrosis emphasized the importance of the pre-operative investigation of the upper urinary tract. Only displacement and mild dilatation of the distal ureters is not detectable by sonography. Therefore in malignant tumours of the genital tract the pre-operative intra-venous pyelogram is still recommended.

Adult↗

PubMed1989

Effects of information to patients undergoing intravenous pyelography: an intervention study.

This paper reports on the outcome of nursing intervention consisting of information-giving to patients about to undergo a threatening medical event (intravenous pyelography). Thirty patients in an intervention group were given structured information on all aspects of the examination (sensory, procedural and temporal components, and a coping mechanism). Their reactions to the event as recorded in self-reports were compared with those of 30 patients who did not receive such information (control group). No differences were found between the groups regarding physiological reactions to the stressful event, but there were clear and partly significant differences in the psychological outcome variables. Less pain and discomfort were experienced during intravenous pyelography in the intervention group and the subjects of this group were better able to form mental images of the impending event.

Adaptation, Psychological↗

PubMed1987

Acute tubular necrosis complicating bilateral retrograde pyelography.

Acute renal failure following retrograde pyelography is a rare occurrence. The mechanisms reported have focused upon urinary tract obstruction either at an intrarenal or ureteric level. This report describes the first biopsy-proven case of acute tubular necrosis complicating retrograde pyelography. We propose the etiology to be direct tubular toxicity resulting from pyelolymphatic reflux of contrast.

Acute Kidney Injury↗

PubMed1983

Intrarenal backflow during retrograde pyelography with graded intrapelvic pressure. A pathoanatomic study.

Histologic examination was performed in 21 baby-pig kidneys after retrograde pyelography with a mixture of meglumine sodium diatrizoate and Ferritin at intrapelvic pressures of either 30-35 or 70-75 mm Hg. In further 4 kidneys light microscopy was done after retrograde pyelography with a mixture of barium sulfate and gelatin at an intrapelvic pressure of 70-75 mm Hg. The primary pathway for intrarenal backflow was canalicular. The contrast material entered the interstitium only by one route: Tubular leakage. Only in the central portions of the kidney leakage was seen. Interstitial Ferritin was found more frequently in areas with intrarenal backflow at an intrapelvic pressure of 70-75 mm Hg than of 30-35 mm Hg.

Animals↗

PubMedDate not supplied

Percutaneous ultrasound-guided pyelography aided diagnosis of ectopic ureter and hydronephrosis in a 3-week-old filly.

Ultrasound-guided percutaneous pyelography has previously been used in dogs to diagnose ectopic ureter. To the authors' knowledge its use has never been reported in the horse. This paper reports the technique used in a three-week-old filly with a suspected ectopic ureter. Pyelography can be performed under sedation and is a relatively simple, safe procedure. The technique enables assessment of individual renal function through collection and analysis of urine from each renal pelvis.

Animals↗

PubMed1994

Value of dimercaptosuccinic acid single photon emission computed tomography and magnetic resonance imaging in detecting renal injury in pediatric patients with vesicoureteral reflux. Comparison with dimercaptosuccinic acid planar scintigraphy and intravenous pyelography.

The value of 99mTc-dimercaptosuccinic acid (DMSA) planar renal scintigraphy, DMSA single photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI) in the assessment of renal injury related to vesicoureteral reflux (VUR) was examined in 60 kidneys of 32 pediatric patients (28 bilateral, 4 unilateral) with primary VUR. The results were: (1) detection of minor renal lesions was best with MRI, then DMSA-planar and DMSA-SPECT, and (2) in comparing the positive rate, DMSA-SPECT (85%) and MRI (83.3%) were superior to intravenous pyelography (55%) and DMSA-planar scintigraphy (65%). These results suggest that DMSA-SPECT or MRI may be more sensitive than DMSA-planar scintigraphy and intravenous pyelography in detecting renal injury related to VUR in pediatric patients.

Child↗

PubMed1983

Pressures during retrograde pyelography.

Model experiments were conducted to simulate the conditions of injection rate and pressure during retrograde pyelography. Pressures at the upper and lower end of a Ch. 5 and Ch 6. ureteral catheter were determined with 30% and 45% sodium meglumine diatrizoate and water and with different needles allowing leakage of the injected medium from a reservoir at the upper end of the catheter. It is concluded that the pressure at the upper end of the catheter may be kept within physiologic range if (1) the contrast medium is injected slowly, (2) the contrast medium leaks back around the ureteral catheter into the bladder and (3) a contrast medium with a low viscosity is used. It is advisable to use a Ch. 5 ureteral catheter instead of a Ch. 6 for retrograde pyelography.

Diatrizoate Meglumine↗

PubMed1975

Percutaneous antegrade pyelography in small infants and neonates.

Percutaneous antegrade pyelography is a safe and useful alternative to retrograde pyelography in the investigation of urinary-tract malformations in the neonate or very young infant. It is preferred to arteriography in the infant with a loin mass. Satisfactory delineation of hydronephrosis or cysts is simply and directly accomplished by this method, so that more complex and less definitive investigations can often be avoided. In addition, a variety of ureteric abnormalities may be displayed.

Aortography↗

PubMed1977

The diagnostic value of intravenous pyelography in infravesical obstruction in males.

Intravenous pyelographies from 104 consecutive patients admitted for infravesical obstruction were studied with special reference to pathology of the upper urinary tract and the bladder, the size of the prostate and the bladder emptying. The incidental findings in the upper urinary tract did not influence the treatment of the infravesical obstruction. Furthermore the radiographic assessment of prostatic size, bladder trabeculation, bladder emptying, bladder stones and prostatic cancer was very uncertain. Thus intravenous pyelography in our opinion should not be performed as a routine procedure in patients with benign prostatic hypertrophy, but only on clinical suspicion of upper urinary tract pathology.

Adult↗

PubMed1999

MR pyelography and conventional MR imaging in urinary tract obstruction.

PURPOSE: To evaluate the possible role of MR imaging in the assessment of patients with urinary tract obstruction by combining conventional MR imaging and MR pyelography (MRP). MATERIAL AND METHODS: Forty-three patients with dilated upper urinary tract were studied with a high gradient strength 0.5 T magnet. Respiratory compensated T1-weighted, SE and T2-weighted TSE sequences were acquired in all patients. MRP images were obtained by using a respiratory compensated 3D T2-weighted TSE sequence. MRP images were reconstructed with a MIP algorithm. In all cases, urography and/or ascending pyelography were also performed. Images were independently evaluated by two radiologists. RESULTS: The dilated tract ureter and the level of the obstruction could be correctly demonstrated in all cases. The cause of the obstruction was correctly demonstrated by examiner 1 in 90% and by examiner 2 in 88%. The interobserver agreement was high with a kappa-value of 0.96. CONCLUSION: In cases of obstructive hydroureteronephrosis MR imaging, combining MRP and conventional sequences, can be proposed as an accurate technique in the assessment of level and cause of obstruction.

Aged↗

PubMed1978

Renal injury associated with intravenous pyelography in nondiabetic and diabetic patients.

We studied 23 patients with renal functional deterioration after intravenous pyelography; 16 were nondiabetic. Nondiabetic patients at risk are often elderly and have preexisting renal disease. The course of acute renal failure is fairly characteristic; most patient recover, but some do not. Estimates suggest that the syndrome is not uncommon in susceptible nondiabetic subjects. Pyelography cannot be considered absolutely safe for this group, and alternative diagnostic procedures or caution with contrast dosage and patient preparation may be wise.

Acute Kidney Injury↗

PubMed1976

Fine needle biopsy of metastases at retrograde pyelography, directed by fluoroscopy. Report of a case with malignant teratoma of the testis.

Percutaneous fine needle aspiration biopsy was performed at retrograde pyelography in order to differentiate between metastatic and scarry involvement of a strictured ureter in a patient earlier operated upon because of malignant teratoma. The method is recommended in patients with malignant diseases where the differential diagnosis is impossible to establish at retrograde pyelography or urography.

Adult↗

PubMed1992

[Usefulness of catheter pyelography in ileal diversions and continent bladder replacement after radical cystectomy].

Transcatheter ascending pyelography is commonly performed in the post-operative evaluation of patients submitted to ileal diversion or continent bladder replacement after radical cystectomy. The present study investigated the usefulness of this procedure in the control of these patients. Of 51 patients that underwent cutaneous ileal diversion, the IVP revealed a leak of the contrast medium in only one case (1.9%). Of the 18 patients that received a continent neobladder, radiologic signs of changes were detected in 6 cases (33.3%). The complications of the IVP in our patients were fever in 26 patients (37.7%) and septicemia in one patient (1.45%). Considering the information obtained and the rate of morbility, we believe that ascending pyelography through catheters is not justified in the routine post-operative control of patients who have undergone radical cystectomy and ileal diversion. However, it appears to be a useful procedure in those cases that have undergone bladder replacement and/or continent diversion procedures.

Cystectomy↗

PubMed1992

Role of ultrasound guided percutaneous antegrade pyelography (USPCAP) in the diagnosis of obstructive uropathy.

Ultrasound guided percutaneous antegrade pyelography (USPCAP) was performed in 6 cases between 1 month and 8 years age, presenting with obstructive uropathy. The procedure in this age group was characterized by (i) ease of performance without sedation in the neonates and with sedation in older children, and (ii) use of smaller needles and catheters. The procedure enabled delineation of the intimate anatomy of complicated urological abnormalities such as obstructed duplex system, primary megaureters, posterior urethral valves, prune belly syndrome, obstructive hydronephrosis and vesicoureteric reflux. Percutaneous renal puncture may be established rapidly using ultrasonic guidance in severely ill pediatric patients with obstructive uropathy. B-mode ultrasonography has proved to be rapid, accurate and free of radiation hazards, making it applicable to children with little or no sedation. Guided by ultrasound, percutaneous antegrade pyelography should be considered in the few, selected children with obstructive uropathy when the diagnosis is critical for management and difficult with the usual imaging procedures.

Child↗