Antegrade pyelography, a survey among urologists

Area of Science:

• Urology
• Medical Imaging
• Procedural Guidelines

Background:

• Antegrade pyelography (APG) is essential for upper urinary tract imaging.
• Current APG implementation lacks standardized protocols and evidence-based guidelines.
• Variability in practice may impact complication rates, particularly urosepsis.

Purpose of the Study:

• To assess current practice patterns in antegrade pyelography (APG).
• To investigate pre-procedural prophylaxis and contrast administration methods in APG.
• To estimate the incidence of complications, such as urosepsis, associated with APG.

Main Methods:

• A digital survey was distributed to European Association of Urology (EAU) members.
• Fifty urologists reported on antibiotic use, pressure, contrast administration, and urosepsis rates.
• Data analysis included calculation of percentages and 95% confidence intervals (CI).

Main Results:

• Antibiotic prophylaxis was consistently used by 42% of urologists.
• Contrast administration via syringe was reported by 70% of respondents.
• A local guideline for APG was utilized in only 8% of cases, with an estimated 4% urosepsis rate.

Conclusions:

• Significant variation exists in APG procedures, despite the risk of urosepsis.
• There is an urgent need for standardized guidelines and consensus on APG performance.
• Low survey response rates limit the generalizability of the findings, highlighting the need for further research.