[Urodynamic exploration of the upper urinary tract. III. Recovery of obstructed kidney function]

In cases of severe obstructive nephropathy, the quantification and potential reversability of a hydronephrotic atrophy is a fundamental factor in the choice between conservative and radical surgery. The information provided by non-invasive techniques, like excretory urography and the modern isotopic techniques, is limited by intercurrent phenomena, like infection and/or additional obstructive phenomena, which are frequent in patients presenting with hydronephrotic atrophy. It is therefore necessary, in such cases, to rely on direct procedures giving precise information concerning individual renal function, and, more particularly on percutaneous nephrostomy. The author's personal experience suggests that this procedure greatly improves the prognosis. But its results may be predictable in the light of a comparison of the analytical, manometric and radiological data provided by a transcutaneous punction of the kidney. In that event, it follows that the percutaneous nephrostomy is, of course, no longer indicated.