Diagnostic value of distended urinary bladder pyelography in adults

Intravenous pyelography carried out with a previously distended bladder in order to produce partial urinary flow obstruction offers superior delineation of the pelvi-caliceal system and ureters. Often, these structures are visible in their entirety on a single film. In 100 adult patients of both sexes who had undergone conventional i.v. pyelography, a second examination was carried out without external compression, after preliminary distension of the urinary bladder (DUB). DUB was achieved by three different methods. In 25 patients the urinary bladder was distended by retrograde instillation of saline. Another 25 patients retained their overnight urine and 50 others retained their urine following a water load of 1,000 ml. Best results were obtained in patients examined by the retrograde and water-load methods. The vast majority of examinations in these groups were of superior quality compared with that obtained by the routine technique. Pyelography with a distended bladder proved to be a valuable diagnostic adjunct in all instances in which application of external compression is undesirable, particularly in cases of trauma.