Identification of ureteroileal obstruction by retrograde loopography

Retrograde loopography in 106 patients (212 renal units) with ileal conduit urinary diversion was assessed to define the accuracy of this study in identifying ureteroileal obstruction. In 171 renal units (81%), the radiographic findings demonstrated by retrograde loopography correlated appropriately with the findings on excretory urography. However, in 41 renal units (19%) with absent ileoureteral reflux, there was no evidence of ureteroileal obstruction by excretory urography. This potential disparity between excretory urography and retrograde loopography has limited our use of the latter study for selected patients in whom the excretory urogram demonstrates (1) evidence of progressive upper tract deterioration, (2) anastomotic obstruction, or (3) patients with chronic renal failure or iodide sensitivity in whom the intravenous administration of contrast material may be contraindicated.