Diuretic renography and urodynamic pressure studies in evaluating dilated bilharzial ureters. A preliminary report

A prospective trial was done in 30 ureters in 21 patients using perfusion pressure flow studies (PPFS) and diuretic renography with washout technique (DRWT) in dilated bilharzial ureters in order to diagnose the presence or absence of obstruction and to compare the results. PPFS could not be done in 11 ureters due to technical problems. Three categories of results were obtained: 1) no obstruction could be demonstrated by either PPFS or diuretic renography (11 ureters), 2) obstruction was confirmed by both methods (three ureters), and 3) obstruction was shown by DRWT but could not be proven by PPFS (five ureters). DRWT, which is a noninvasive method, gave the correct diagnosis in the majority of cases and should be the first method used to evaluate dilated bilharzial ureters. In cases where DRWT shows no obstruction, further evaluation is unnecessary, as PPFS did not show obstruction in these cases either. But in cases where obstruction is shown by DRWT, PPFS should be tried to confirm the obstruction before surgery is performed.