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Related Experiment Videos

Upper urinary tract videourodynamics: a more complete Whitaker test.

S B Radomski1, M E Moran, A R Stone

  • 1Assistant Professor, Division of Urology, The Toronto Western Hospital and University of Toronto, Toronto, Ontario.

The Canadian Journal of Urology
|July 1, 1995
PubMed
Summary

This study modified the Whitaker test for diagnosing urinary obstruction using a single nephrostomy tube. The enhanced method accurately identified obstruction in five patients, improving diagnostic completeness.

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Area of Science:

  • Urology
  • Nephrology
  • Diagnostic Imaging

Background:

  • The Whitaker test is a standard method for evaluating urinary tract obstruction.
  • Traditional methods may require multiple access points, increasing invasiveness.
  • Accurate differentiation between obstructive and non-obstructive causes of hydronephrosis is clinically crucial.

Purpose of the Study:

  • To describe a modified Whitaker test utilizing a single nephrostomy tube for improved efficiency and accuracy.
  • To evaluate the efficacy of this modified technique in diagnosing renal pelvic obstruction.

Main Methods:

  • A modified Whitaker test was performed using a single nephrostomy tube for both fluid infusion and pressure monitoring.
  • Ureteral transit time and fluoroscopic imaging were incorporated into the protocol.

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  • The modified test was applied to ten patients presenting with symptoms or imaging suggestive of urinary obstruction.

    • Main Results:

    • The modified technique successfully differentiated between obstructed and non-obstructed cases in all ten patients.
    • Five patients showed no evidence of obstruction (renal pelvic pressure ≤10 cm H2O).
    • Five patients demonstrated obstruction (renal pelvic pressure >20 cm H2O), with four distal and one proximal.

    Conclusions:

    • The modified Whitaker test, incorporating a single access port, ureteral transit time, and fluoroscopy, is a complete and effective method for diagnosing urinary obstruction.
    • This streamlined approach simplifies the procedure while maintaining diagnostic accuracy.
    • The enhanced interpretation aids in clinical decision-making for patients with suspected upper urinary tract obstruction.