Predictive value of renography and i.v. urography for the outcome of reconstructive surgery in patients with...

Intravenous urography and isotope renography studies were made in 54 patients with hydronephrosis. Thirty six of these patients underwent reconstructive surgery and were also studied postoperatively. Both studies gave more or less consistent results - that is to say evaluations of renal function and drainage from each individual study were similar - but no individual parameter was of any specific significance in the selection of patients for therapy. Points were allocated to each parameter, and after summing these points for each individual patient, 3 groupings became apparent: a low count group - patients with pelvectasia but normal renal function:a middle count group - patients with certain hydronephrosis; and a high count group with severe hydronephrosis, and markedly impaired renal function. Post-operatively, renal function was unaltered or mildly reduced in group 1, and improved in groups 2 and 3, though the differences were not statistically significant. It was hoped that the studied would allow differentiation between patients of the low count group, but the conundrum remains - which of them can be categorized as normal variants, and which were in fact displaying early pathological signs of essentially progressive disease.