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Related Experiment Videos

Whitaker test: differentiation of obstructive from nonobstructive uropathy.

R B Jaffe, A W Middleton

    AJR. American Journal of Roentgenology
    |January 1, 1980
    PubMed
    Summary

    The Whitaker test, a urodynamic study, helps differentiate obstruction from permanent changes in the urinary tract after surgery. This evaluation is crucial for managing persistent upper urinary tract dilatation and guiding treatment decisions.

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    Area of Science:

    • Urology
    • Pediatric Urology
    • Nephrology

    Background:

    • Persistent upper urinary tract dilatation after surgical correction of obstruction requires accurate diagnostic methods.
    • Differentiating residual/recurrent obstruction from permanent changes is critical for patient management.

    Observation:

    • The Whitaker test involves perfusing the upper urinary tract via percutaneous renal pelvis puncture or nephrostomy tube.
    • Serial pressure recordings in the renal pelvis and bladder are obtained during perfusion at 5-10 ml/min.
    • Videotaping of ureteral peristalsis and spot films supplement pressure data.

    Findings:

    • Nonobstructed systems tolerate high flow rates without significant renal pelvic pressure rise.
    • Obstructed systems demonstrate abnormally high renal pelvic pressure (>12 cm H2O) or a progressive pressure increase.

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  • The Whitaker test effectively distinguishes between functional obstruction and fixed anatomical changes.

    • Implications:

    • This urodynamic study aids in managing complex cases of ureteropelvic junction (UPJ) or ureterovesical junction (UVJ) obstruction.
    • It is valuable for evaluating primary ureteral musculature defects, like prune-belly syndrome.
    • The test helps determine the safe discontinuation of urinary diversion in postoperative patients.