Value of kidney-ureter-bladder radiography in the erect position in addition to standard intravenous urography examination

To determine if additional kidney-ureter-bladder radiography in the erect position can improve the diagnostic yield of standard intravenous urography [IVU] examination. This prospective study was conducted from March to July 2007 on 108 consecutive patients [65 males and 43 females, age ranging from 20 to 50 years] who were referred to the Department of Radiology, Al-Amiri Hospital, Kuwait, for IVU examinations. After 15 min, a film was done in the erect position in addition to the routine IVU protocol. Additional information was demonstrated in the erect radiograph as follows: detecting nephroptosis in 18 [17%] patients, improved visualization of the ureters in 58 [54%] patients, and differentiation between phleboliths and ureteric stone was possible in 12 [11%] patients. Our study demonstrated significant additional findings in the erect position [at 15 min] compared to the supine position

Unenhanced Spiral CT in Acute Ureteral Colic: A Replacement for Excretory Urography?

OBJECTIVE: To compare the usefulness of unenhanced spiral CT (UCT) with that of excretory urography (EU) in patients with acute flank pain. MATERIALS AND METHODS: Thirty patients presenting with acute flank pain under-went both UCT and EU. Both techniques were used to determine the presence, size, and location of urinary stone, and the presence or absence of secondary signs was also evaluated. The existence of ureteral stone was confirmed by its removal or spontaneous passage during follow-up. The absence of a stone was determined on the basis of the clinical and radiological evidence. RESULTS: Twenty-one of the 30 patients had one or more ureteral stones and nine had no stone. CT depicted 22 of 23 calculi in the 21 patients with a stone, and no calculus in all nine without a stone. The sensitivity and specificity of UCT were 96% and 100%, respectively. EU disclosed 14 calculi in the 21 patients with a stone and no calculus in eight of the nine without a stone. UCT and EU demon-strated secondary signs of ureterolithiasis in 15 and 17 patients, respectively. CONCLUSION: For the evaluation of patients with acute flank pain, UCT is an excellent modality with high sensitivity and specificity. In near future it may replace EU.

Ureteroscopy vs ESWL in the management of ureteric stones pro and conta!

In this retrospective study, we evaluated the results of rigid ureteroscopy and ESWL in the management of lower ureteric stones. One hundred and eighteen patients with ureteric stones were included in this study. Seventy eight patients were subjected to Ureteroscopic manipulations and forty patients to ESWL using Siemens Lithostar. The total success rate of ureteroscopy was 89.7%, compared to 62.5% with ESWL. There have been no significant late sequelae of the procedures. Transurethral ureteroscopy appears to offer an alternative to the existing therapeutic options, when in situ ESWL or push-pull technique through PCN is not successful

Preliminary report: the role of ultrasonography in the diagnosis of obstructed terminal ureter

The recent rapid advancement in the ultrasonic equipment and imaging has led to widespread clinical application in the field of urology and stone detection. In this study we use the filled urinary bladder as a window for ultrasonic waves to visualize the terminal ureteric obstruction. Forty one patients complaining of renal colic were studied by plain X-ray, I.V.U. and ultrasonography. The ultrasonic results were compared to plain X-ray and I.V.U. findings. The results shows that sonography was superior in the diagnosis of stone and stricture