[Renal scintigraphy under hyperdiuresis in upper urinary tract dilatations]

Area of Science:

• Urology
• Nuclear Medicine
• Diagnostic Imaging

Background:

• Dilatation of the upper urinary tract can stem from obstructive or non-obstructive causes.
• Accurate diagnosis is essential for appropriate patient management and surgical planning.

Purpose of the Study:

• To evaluate the efficacy of renal scintigraphy with technetium-labelled DTPA and a Lasilix test in differentiating obstructive from non-obstructive upper urinary tract dilatation.
• To correlate scintigraphic findings with intra-operative findings and patient outcomes.

Main Methods:

• Renal scintigraphy using technetium-labelled DTPA combined with a Lasilix diuretic test was performed on 34 patients with 41 dilated renal units.
• Intra-operative exploration was conducted for units assessed as potentially obstructed.
• Patient outcomes were monitored following medical or surgical treatment.

Main Results:

• Scintigraphy correctly identified obstruction in 14 cases of pyelo-ureteral junction anomalies and 3 mega-ureters, confirmed intra-operatively.
• Non-obstructive hypotony was diagnosed in 12 units via scintigraphy and confirmed by surgical outcomes.
• Urinary tract drainage improved post-operatively in obstructed cases and following ureteral reimplantation for reflux without resection.

Conclusions:

• Renal scintigraphy with DTPA and Lasilix test is a reliable method for distinguishing obstructive from non-obstructive upper urinary tract dilatation.
• Prompt surgical resection of obstructed segments is necessary for effective urinary tract emptying.
• Non-obstructive conditions, such as reflux in wide ureters, can be successfully managed with appropriate surgical techniques.