Renal scintigraphy in initial evaluation of renal colic.

To determine the role of renal scintigraphy (RS) in patients with suspected acute urinary tract obstruction, a prospective study was performed comparing RS with emergency intravenous excretory urography (IVU) in 36 examinations. Thirty patients were diagnosed as having renal colic: 28 had dilation of the urinary tracts with (89%) or without (11%) visualized stone; 2 patients with stones did not have stasis at the IVU. An abnormal RS was found in 28 patients with abnormal IVU, while it was normal in the 2 nonobstructed patients (sensitivity = 93%). The radiopaque stones in these 2 patients were seen on plain x-ray film of the abdomen. The results of this study support the use of RS combined with a plain film of the abdomen in the initial evaluation of renal colic.

Radionuclide assessment of bladder-emptying function in normal male population and in patients before and after prostatectomy.

Radionuclide assessment of the bladder-emptying function was evaluated in 82 normal individuals and in 16 patients before and after prostatectomy. The parameters evaluated were: average flow rate (AFR), peak flow rate (PFR), corrected peak flow rate (CPFR = PFR/[bladder volume] 0.5), ejection fraction (EF) of the bladder, and post-voiding residual urine (RU) volume. A good interobserver reproducibility was found in 19 measurements. Urinary flow rates, EF, and RU showed a highly significant statistical difference between normal individuals and patients before surgery: AFR, 9.2 +/- 5.1 vs. 2.9 +/- 1.5 mL/sec; PFR, 19.5 +/- 9.2 vs 7.4 +/- 3.2 mL/sec; CPFR, 1.17 +/- 0.34 vs 0.54 +/- 0.22; EF, 95.6 +/- 4.6 vs 68.2 +/- 23.2 percent; and RU, 11.8 +/- 15.8 vs 93.4 +/- 115 mL; respectively. After prostatectomy the urinary flow rates showed a highly significant improvement and did not differ from the normal individuals: AFR, 7.9 +/- 2.7 mL/sec; PFR, 19.0 +/- 6.4 mL/sec; and CPFR, 1.32 +/- 0.57. The EF after surgery (91.7 +/- 10.9%) was lower than in normal individuals, but showed a significant improvement compared with EF before surgery. The RU after surgery (27.4 +/- 48.0 mL) although lower than before surgery did not differ significantly and was greater than in the normal individuals. No relationship between age and flow was found in this study. Both average and peak flow rates were related to the bladder volume. This method involves a single, noninvasive procedure which enables determination of bladder-emptying function.

Radionuclide measurement of bladder emptying rate. Simultaneous comparison with urinary flow rate obtained by uroflowmetry.

Mean and peak bladder emptying rates were measured by a radionuclide method using a gamma camera and Tc-99m DTPA and were compared with average and maximum urinary flow rates obtained by a uroflowmeter in 24 simultaneous measurements. A good correlation was found between the two methods. Average urinary flow rate correlates better with mean bladder emptying rate (r = 0.96, y = 1.04X + 0.14, s.e.e. = 1.2) than maximum urinary flow rate with peak bladder emptying rate (r = 0.83, y = 0.78X + 4.5, s.e.e. = 4.2). The results suggest that the radionuclide method can be used to measure the urinary flow rate, and has the advantage of establishing the postvoid residual urine.

Radionuclide assessment of bladder outlet obstruction: a noninvasive (1-step) method for measurement of voiding time, urinary flow rates and residual urine.

Radionuclide uroflowmetry was performed in 23 patients with bladder outlet obstruction and 29 controls. The parameters evaluated were voiding time, time to peak flow rate, time for 50 per cent emptying, average flow rate, peak flow rate, corrected peak flow rate [peak flow rate/(bladder volume)0.5], ejection fraction of the bladder and post-void residual urine. There was a statistically significant difference between controls and patients with bladder outflow obstruction in each parameter: voiding time 28.2 +/- 9.3 versus 49.2 +/- 26.5 seconds, time to peak flow rate 13 +/- 4.1 versus 19 +/- 12.6 seconds, time to 50 per cent emptying 5.5 +/- 2.4 versus 25.7 +/- 26.9 seconds, average flow rate 9.1 +/- 3.7 versus 4 +/- 2.3 ml. per second, peak flow rate 19.6 +/- 7.6 versus 8.8 +/- 4.1 ml. per second, corrected peak flow rate 1.22 +/- 0.32 versus 0.59 +/- 0.22, ejection fraction 95.3 +/- 3.5 versus 79.7 +/- 17.6, and residual urine 13.1 +/- 13.5 versus 74.1 +/- 135 ml., respectively. The corrected peak flow rate showed the best separation between controls and patients with obstruction. Of the controls 93 per cent had a corrected peak flow rate of 0.87 or greater compared to only 13 per cent of the patients with obstruction. This method involves a single noninvasive procedure that enables determination of voiding parameters related to urinary volume, flow and time, and it avoids the extra examination needed to determine the residual urine.