The application of retrograde pyelography in the diagnosis of traumatic ureteropelvic junction disruption in children / 中华泌尿外科杂志

Objective To explore the application of retrograde pyelography with traumatic ureteropelvic junction disruption in children.Methods A retrospective study was conducted for a total of 26 children with doubt of traumatic UPJ disruption in image from 2009 January to 2017 September.There were 19 males and 7 females with a mean age of 5.4 (1-11) years.And the causes were traffic accident (n =15),fall injury (n =4) and fall damage (n =7).Ultrasound and CT examination indicated different degrees of urinary extravasation in all cases.Enhanced CT delayed imaging had no ureteral enhancement,and could not specify whether UPJ was disrupted.All the patients underwent retrograde pyelography through cystoscope under the general anesthesia.If the retrograde tube entered the renal pelvis smoothly,and the ureter and renal were complete,which was considered to be renal injury.If it was difficult for the tube to reach the UPJ,and the ureteral blind end was shown by contrast angiography,UPJ fracture was considered.Results UPJ was not broken in 9 patients (34.6％),and the peritoneal urine was gradually absorbed after conservative treatment.Retrograde pyelography showed no sign of kidney in 16 cases (61.5％).UPJ disrupture was considered and performed renal exploration.These 16 cases were all confirmed as UPJ disrupture during operation.15 patients underwent ureteropelvic anastomosis,1 patient underwent ureteral anastomosis by using appendix because of long segment defect,and intravenous pyelography after surgery showed that the ureter was unobstructed.Urinoma but not renal was enhanced in 1 patient (3.9％).One case (3.9％) retrograde pyelography showed the perirenal urinary cyst was enhanced,the kidney was not enhanced,and the possibility of UPJ fracture was considered.But this patient was confirmed UPJ not disrupted in the operation and underwent pyeloplasty.Intravenous pyelography showed no contrast agent extravasation after surgery.The sensitivity and specificity of retrograde pyelography in this group were 100％ (16/16) and 90％ (9/10),respectively.Conclusions The sensitivity and specificity of retrograde pyelography were higher,and retrograde pyelography was reliable and irreplaceable in the early diagnosis of UPJ disrupture.

Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

During the period from Jan. 1980 to Dec. 1982, 57 patient were taken RGP and the followings were obtained. 1) RGP was performed 57 patients. 2) Indication was 15 cases (26.3%) of non-visualizing kidney, 17 cases (29.8%) of hydronephrosis, 6 cases (10.5%) of delayed visualization, 13 cases (22.8%) of abnormal findings of calices and pelvis, 2 cases(3.5%) of congenital anomalies of ureter, 1 case (1.8%) of allergy to contrast medium and 3 cases (5.3%) of impaired renal function. 3) Of the 57 patients, 47 patients were defined with RGP and remained 10 patients had been taken other urologic examination for further evaluation.

A Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

We reviewed the 46 cases of retrograde pyelography which performed in the Department of Urology, Chosun University Hospital during the period January 1981 to December 1982. And the results were as follows. 1. The cases were consisted of 23males and 23females. The most common age group was 40-49. 2. The common symptoms on admission were flank pain(50%) and gross hematuria(15.3%). 3. The urine findings(before RGP) revealed hematuria in 15 cases, pyuria in 12 cases, proteinuria in 5 cases and AFB positive in urine in 3 cases. 4. The IVP findings that were performed RGP classified into 4 groups as follows, 1) Abnormal changes or poor visualization of calyx, pelvis and ureter: 5 cases(10.8%) 2) Hydronephrosis: 13 cases(28.3%) 3) Delayed visualization: 18 cases(39.1%) 4) Non visualization: 10 cases(21.7%). 5. Of the 46 patients, most patients were defined with RGP and 24 cases had been required other special urologic studies for further evaluation.

A Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

Authors reviewed 110 cases of retrograde pyelography which performed in the Dept. of Urology, Kyung Hee University Hospital during the period from January 1977 to December 1980. And the results were as follows. 1. Indication was 34 cases (31%) of nonvisualizing kidney, 31 cases (28%) of obstructive lesion, 21 cases (19%), of inadequate filling in pelviocalyceal system, 7 cases (6.5%) of impaired renal function. 6 cases (5.5%) of upper tract abnormality, l cases (0.9%) of allergy to contrast media and other 10 cases. 2. On the nonvisualizing kidney, hydronephrosis (23.5%) was most common and normal (20.5%), ureter stone (20.5%) in order. 3. For assessment of obstructive lesion, UPJ stricture (39%) was most common and ureter stone (32%), normal (16%), ureter tumor, UVJ stricture in order. 4. Inadequate filling on excretory urogram revealed normal (24%), renal tumor (19%), renal tuberculosis (9.5%) and chronic pyelonephritis scar (9.5%) etc. 5. The patients who had poor renal function or poor general condition and upper tract abnormality were well defined with retrograde pyelography and available for diagnosis and treatment. 6. Complication were seen in 2 cases (1.8%). One was acute pyelonephritis and the other was pyonephrosis.

Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

During the period from January 1978 to December 1980, 46 patients who were taken RGP were analyzed and observed as follows. 1) RGP was performed 46 patients who were not defined exactly on IVP. 2) Undefined findings on IVP that was performed RGP classified into four group as follows. Group I : Abnormal changes or poor visualization of calyx, pelvis and ureter; 17 (32.7%) Group II : Hydronephrosis; 12 cases (23.1%) Group III : Delayed visualization; 9 cases (17.3%) Group IV : Non-visualization; 14 cases (26.9%) 3) Of the 46 patients (52 kidneys), 35 patients (41 kidneys) were defined with RGP and remained 11 patients (11 kidneys) had been required other special urologic studies for further evaluation.