Diuresis Renography in Equivocal Upper Urinary Tract Obstruction

Chang, Sae Yong; Kim, Tai Chin

Abstract

It is well recognized that dilation of upper urinary tract can occur in the absence of either reflux or mechanical obstruction. The demonstration of the cause of upper urinary tract dilation may critically alter the management of a patient. So several diagnostic methods were designed to demonstrate it, but their clinical application were not satisfactory due to inaccuracy, invasiveness and technical difficulty. Diuresis renography has recently been introduced as a method of evaluating upper urinary tract dilation found on intravenous urography. It is a simple, rapid, non invasive test which has enable to define the cause. 23 cases which have equivocal upper urinary tract dilation on intravenous urography were examined by diuresis renography in the Department of Urology, Kyung Hee University Hospital, during the period from October 1980 to March 1982 and three differential categories were obtained as follows. 1. Normal type (9 cases): Both standard and diuresis renograms were normal. 2. Obstructive type (3 cases): Initial renogram was obstructive and remained so during diuresis. 3 cases in this category were confirmed by operation and follow-up intravenous urography. 3. Atonic type (11 cases): Initial renogram tracing was obstructive but rapid isotope elimination occurred after diuresis.