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Related Experiment Videos

[Antegrade pyelography].

A Hoshina, Y Yamasaki, M Kato

    Hinyokika Kiyo. Acta Urologica Japonica
    |July 1, 1985
    PubMed
    Summary
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    Ultrasonic-guided percutaneous antegrade pyelography is a safe and effective method for diagnosing obstructive hydronephrosis when other imaging fails. This minimally invasive technique provides crucial diagnostic information for various renal and ureteral conditions.

    Area of Science:

    • Urology
    • Diagnostic Imaging
    • Nephrology

    Background:

    • Obstructive hydronephrosis often presents challenges for conventional imaging techniques like excretory urography.
    • Retrograde pyelography may not be feasible in all cases of obstructive hydronephrosis.
    • There is a need for safe and accurate imaging modalities to visualize the renal collecting system in complex cases.

    Observation:

    • Percutaneous antegrade pyelography (PAP) was performed under real-time ultrasonic guidance in 18 patients with obstructive hydronephrosis.
    • The procedure involved local anesthesia, renal pelvis needle insertion, fluid aspiration for cytology/culture, and contrast injection.
    • Radiograms and delayed films were obtained for diagnostic assessment.

    Findings:

    • PAP successfully diagnosed pelvic and/or ureter tumors in 8 cases.

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  • Congenital anomalies, including ureteropelvic and ureterovesical junction obstructions, were identified in 2 cases.
  • Ureteral ligation (3 cases) and ureteral stenosis (5 cases) were also diagnosed.
  • Dark-red urine and positive cytology in 6 cases were associated with pelvic/ureter tumors.
  • The procedure demonstrated a high safety profile with no severe complications.

    • Implications:

    • Ultrasonic-guided PAP is a valuable, safe, and accurate diagnostic tool for obstructive hydronephrosis.
    • It offers significant diagnostic advantages in cases where standard pyelography is unsuccessful or contraindicated.
    • The technique aids in the timely diagnosis of tumors, congenital anomalies, and other ureteral pathologies, guiding appropriate management.