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Identification of ureteroileal obstruction by retrograde loopography
Urology
|February 1, 1981
Summary
Retrograde loopography accurately identifies ureteroileal obstruction in most cases following ileal conduit urinary diversion. However, discrepancies with excretory urography in cases without reflux warrant careful patient selection for this imaging technique.
Area of Science:
- Urology
- Radiology
- Surgical Oncology
Background:
- Ileal conduit urinary diversion is a common surgical procedure for bladder reconstruction.
- Ureteroileal obstruction is a potential complication following this diversion.
- Accurate diagnostic methods are crucial for timely intervention.
Purpose of the Study:
- To evaluate the accuracy of retrograde loopography in detecting ureteroileal obstruction.
- To compare findings from retrograde loopography with excretory urography.
Main Methods:
- Retrospective analysis of 106 patients (212 renal units) who underwent ileal conduit urinary diversion.
- Retrograde loopography was performed to assess for ureteroileal obstruction.
- Findings were correlated with results from excretory urography.
Main Results:
- Retrograde loopography findings correlated with excretory urography in 81% of renal units (171/212).
- In 19% of renal units (41/212), excretory urography showed no obstruction despite retrograde loopography findings.
- Discrepancies were noted in cases without ileoureteral reflux.
Conclusions:
- Retrograde loopography is a valuable tool for identifying ureteroileal obstruction post-urinary diversion.
- Careful consideration of patient selection is necessary due to potential disparities with excretory urography, especially in the absence of reflux.
- Further investigation may be needed for patients with progressive upper tract deterioration, anastomotic obstruction, or contraindications to intravenous contrast.