Infusion Urography Research Articles

Quality of life and indicators of social adaptation in patients with congenital hydronephrosis

Purpose of the study : to study the quality of life, motivational orientation and frustration reactions in patients with congenital hydronephrosis. Quality of life is understood as an integral indicator of living space, personal, subject, professional potential, human health. Materials and methods . The study involved 30 patients aged 13–24 years old who underwent plastic repair of the Priyolan’s segment according to the Heines – Anderson – Kuchera. To study the quality of life, two types of criteria were used: psychodiagnostic (SF-36 questionnaire, assessment of the severity of success motivation S. Shapkin, Rosenzweig test of frustration) and medical (intravenous infusion urography, ultrasound of the urinary system (MFR), computed tomography, radioisotope methods). Results . The data obtained suggests that pronounced pain syndrome significantly reduces the quality of life of patients with congenital hydronephrosis, also reduces the overall indicator of positive emotions, the mood is characterized as anxious and depressive. Conclusion . Anomalies of the urinary system lead to a pronounced violation of the patient's quality of life and his social adaptation. As a result of the study, it was revealed that the pronounced pain syndrome reduces the quality of life of patients, and health limits the exercise of physical activity, daily and professional activities. Also reduced overall positive emotions. In 50% of patients, the motivational orientation is not balanced in terms of avoiding failures and achieving success. A high frequency of extrapunitive frustration reactions was found. All these factors greatly impede the social adaptation of the patient.

Bolus Injection v Drip Infusion Contrast Administration for Ureteral Stone Targeting During Shockwave Lithotripsy

Intraoperative excretory urography may be used to facilitate stone targeting during in situ SWL for ureteral stones, precluding the need for ureteral catheter placement. We compared bolus injection with drip infusion urography for efficacy in stone localization. Twenty-seven patients with normal renal function and a solitary, difficult to visualize, radiopaque ureteral calculus were randomized to receive intravenous contrast by either bolus injection (N = 13) or drip infusion (N = 14). The bolus injection patients received an average of 74 mL of Conray 400 contrast over 1 minute; the drip infusion patients received an average of 92 mL of contrast over 15 minutes. After bolus injection, it took an average of 12 minutes to opacify the ureter compared with 14 minutes after drip infusion (P = 0.62). It took longer to initiate (5 minutes) and complete (6 minutes) treatment after drip infusion than after bolus injection (P = 0.28 and P = 0.16, respectively). Imaging time was significantly longer in the infusion group than in the bolus group (12 v 7 minutes; P = 0.04). Stone-free rates were similar in the two groups: 100% for the bolus group and 91% for the infusion group. No patient in either group experienced an adverse reaction to the contrast. Overall, the two methods of contrast administration were equally efficacious for stone targeting during SWL. However, bolus injection required lesser amounts of contrast, provided more rapid opacification of the ureter, and resulted in an overall shorter procedural time, although the only statistically significant differences were in imaging time and contrast volume.

Comparative Analysis of Bladder Neck Suspension Using Raz, Burch and Transvaginal Burch Procedures

Purpose: Ever since Pereyra described needle suspension of the bladder neck for the treatment of stress urinary incontinence in women, numerous modifications have been presented. There were variations in the success reported by different authors. We report 3-year follow-up results in 146 women operated on for stress urinary incontinence using Raz, Burch and our own new procedures. Materials and Methods: During a 5-year period, 146 women were operated on for genuine stress urinary incontinence. Using the method of Raz, and transvaginal Burch as well as the Burch retropubic urethropexy, a modified bladder neck suspension was performed in 46 (32%), 44 (30%) and 56 (38%) patients, respectively. In all patients a prior gynecological or urological operation for urinary incontinence and a clear neuropathic condition had been excluded before surgery. The routine diagnostic procedure consisted of multichannel cystometry, voiding cystourethrography, infusion urography and cystoscopy. A pressure-flow electromyography study was done in patients with a residual volume greater than 50 ml following voiding. The operations were performed by the same surgeon (I.G.). Initial follow-up was done after 12 months and then every year. Results: Urodynamic testing did not reveal significant differences between Burch and Raz (p = 0.2652), Raz and transvaginal Burch (p = 0.5745) as well as between Burch and transvaginal Burch procedures (p = 0.7602; Fisher’s exact test). Three years after surgery, 50 of 56 (89.3%; Burch procedure), 37 of 46 (80.4%; Raz modification) and 38 of 44 patients (86.4%; transvaginal Burch) were continent. Conclusions: There is no reason (except patient condition) to prefer any of the numerous modifications of bladder neck suspension. We believe that the success of the operation lies in adequate mobilization of the bladder neck and urethra as well as in a surgeon’s familiarity with the procedure.

Bladder outlet resistance decreasing operations in spinal cord damaged patients with vesicoureteral reflux.

Bladder outlet resistance decreasing operations were carried out on 68 spinal cord damaged patients with 87 vesicoureteral refluxes in the Paraplegic Centre, Hamburg, from 1982 to 1988. These patients were studied regularly with infusion urography and voiding cystourethrograms combined with urodynamic procedure. Although the primary aim of the operative treatment was to achieve balanced voiding, 62 (71%) refluxes disappeared, 10 (12%) changed for the better, 13 (15%) stood unchanged and 2 (2%) worsened. It was observed that the results of operative treatment of secondary vesicoureteral reflux depend only on the recuperative capacity of ureterovesical junction after reducing the pathologically increased bladder outlet resistance. Successful treatment of secondary vesicoureteral reflux does not influence renal parenchymal scarring. In all of the patients with unchanged or worsened reflux balanced voiding has still not been achieved, the bladder outlet resistance being not sufficiently decreased.

Ileal loop stenosis: a cause of ilealconduit deterioration (author's transl)

23 children underwent ileal loop urinary diversion between 1964 and 1974. They were 1977 reexamined after an average follow-up of 7 1/2 years. 7 of 22 children were found to have developed a stricture of the ileal loop. The diagnosis of conduit stricture rests primarily upon a tailored infusion urography and may be supplemented in exceptional cases by a low pressure loopogram. The radiographic and endoscopic features of the conduit stricture are presented. This entity usually develops late and silently. A review of the literature shows that the constant urinary exposure of the small bowel results in inflammatory and degenerative changes. The etiology of the conduit stricture has been attributed to these changes. This hypothesis is open to criticism as the entire bowel segment undergoes inflammatory degeneration. In our cases, the stricture always developed at the level of either the left or the right ureteroileal anastomosis. For this reason, a localizing factor has to be taken into account: This could be the usually performed retro- peritonealization of the ureteroileal anastomosis and/or the permanent though minimal traction of a too short ureter which has been divided too high in the pelvis.

Iodine-induced hyperthyroidism due to contrast media (author's transl)

A prospective study in an area with endemic goitre showed 18 patients (15.1%) out of 119 investigated with iodine containing contrast media to be hyperthyroid after 28 days. Oral cholecystography led to the highest (27.9%) and infusion urography to the lowest (5.3%) rate of hyperthyroidism. Determination of the serum concentration of thyroxine, triiodothyronine, basal and stimulated thyrotropine is not a suitable method to detect the risk for hormonally euthyroid patients before a contrast media investigation.

Ultraschalldiagnostik von Nierensteinen

Infusion urography and ultrasound examinations were performed in 54 patients in order to diagnose renal stones. The patients were examined because of upper abdominal pain, suspected renal calculi or for follow-up of known calculi. In 20 patients, stones could be demonstrated by both methods. In four patients, radiological suspicion of the presence of stones was not confirmed by ultrasound. In two patients ultrasound produced false positives and in seven patients renal stones were demonstrated only by sonography. These results were obtained with a mechanical sector scanner. The advantages and disadvantages of compound and of real-time-scanners and their place in the diagnosis of kidney stones are discussed.

Infusion Pyelography in Anuric Patients

The spectrum for the use of retrograde pyelography in renal failure has been narrowed further by extending the facility of infusion urography to anuric patients. The latter study has helped greatly in sifting apart pre-renal and renal anuria patients from those with obstructive uropathy. In obstructive anuria infusion urography hasproved comprehensive in influencing judgment about the exact site and nature of obstruction, in affixing laterality towards the better functioning renal unit and in deciding a suitable definitive operation or planned staged procedures.

Adventitious hysterogram during intravenous pyelography

This study reports our experience with uterine opacification noted during infusion urography. The phenomenon is observed in 21.7 per cent of urograms performed on adult females. Examples of this entity are presented and the pathophysiology of the uterine opacification discussed.

Continuous Infusion Urography in Unilateral Hydronephrosis

In cases of unilateral hydronephrosis the urine concentration of contrast medium, for example diatrizoate, depends on the remaining renal function, the rate of turnover in the obstructed renal pelvis and the function of the contralateral kidney. Contrast medium for a single injection or a short infusion time is rapidly excreted by the normal contralateral kidney, without allowing high enough plasma levels long enough for sufficient urine concentrations in the hydronephrotic kidney. This excretion rate can be compensated for by continuous infusion urography for several hours with large doses of contrast medium (up to 1,250ml. 30 per cent diatrizoate). This method was theoretically computerized, tested in animal experiments and clinically used in 11 patients. It can improve the diagnostic possibilities of excretory urography, especially in cases of unilateral obstruction, and can minimize the need for retrograde pyelography with its known complications.

Traumatic injuries of the renal vasculature and parenchyma

Renal injuries may be classified according to their severity as minor, major, or massive. Roentgenographs and radionuclide investigation are indicated in all patients with gross or microscopic hematuria after trauma. Initial study should include high-dose infusion urography and static renal scintigraphy. If both examinations are within normal limits, no further workup may be necessary. When no contrast medium appears in the kidney during urography, a radiopertechnetate flow study is indicated. Absence of kidney activity during this study is compatible with major arterial occlusion, and prompt angiographic examination should be performed. Segmental areas of impaired visualization on the urogram or of diminished activity on the scintigram in the region of the kidney may represent minor contusion or major injury such as infarct. If the patient's condition is stable and if surgery is not contemplated, angiography may be delayed and possibly omitted. The differentiation between major and minor injury can be made by follow-up nuclide imaging studies. Infarcts remain with persistent defects in the renal image, while contusions demonstrate a return to normal pattern over a period of several weeks. If the patient is unstable, prompt angiographic study may be necessary for immediate definitive diagnosis. Angiography is particularly valuable in rapidly evaluating a patient with intra-abdominal injuries thought to involve more than one organ. Radionuclide and roentgenographic studies of renal trauma have correlated well in previous studies. When the radionuclide study has been normal, no significant injuries have been observed at subsequent angiographic examination. Because of their safety and ease of performance, radionuclide techniques are of great value in these cases, particularly for serial follow-up studies.

UROGRAPHIC FINDINGS IN PATIENTS WITH RENAL FAILURE

Intravenous urography plays an important role in the work-up of the patient in renal failure. In some instances it may be diagnostic in determining the cause of the condition, while at other times its value may be limited to excluding certain diseases. The study should be performed carefully and fully to obtain maximum information. Drip infusion urography with tomography is essential. A review of the types of information and diagnoses that can be obtained are included in the discussion. The importance of ruling out bilateral hydronephrosis as the cause of uremia is stressed.

Evaluation of Renal Trauma by Infusion Urography

Evaluation of Renal Trauma by Infusion Urography

Multiple noduli cutanei and urinary tract abnormalities. A possible significant association.

A patient is described with 17 noduli cutanei (dermatofibromas) and a reduplication in the urinary collecting system. The latter occurred on the right side where, as observed by infusion urography, 2 renal pelves emptied into 2 ureters which were united at the level of L4 (“forked ureter”). Two relatives examined dermatologically and roentgenographically had neither cutaneous nor renal abnormalities. In families previously reported with multiple noduli cutanei, familial hydronephrosis has been a notable feature. Whereas noduli cutanei are of common occurrence when observed as 1 or 2 lesions in a given individual, when present in large numbers (a rarity) they may portend a cutaneo-renal syndrome of possible genetic import.

An evaluation of the effect of high-dose urography on previously impaired renal and hepatic function in man.

HomeRadiologyVol. 97, No. 2 PreviousNext ArticlesAn Evaluation of the Effect of High-Dose Urography on Previously Impaired Renal and Hepatic Function in ManAlan J. Davidson22, Joshua Becker33, Neville Rothfield44, George Unger55, Donald R. Ploch66Alan J. Davidson22, Joshua Becker33, Neville Rothfield44, George Unger55, Donald R. Ploch66Author Affiliations 1600 Divisadero St. San Francisco, Calif. 94115Alan J. Davidson22Joshua Becker33Neville Rothfield44George Unger55Donald R. Ploch66Published Online:Nov 1 1970https://doi.org/10.1148/97.2.249MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractThe authors studied the effects of three common urographie contrast agents on the renal and liver functions of 82 patients with renal and/or liver disease as evaluated by standard function tests. Gross “before-and-after” measurements as well as a correlation of the log of the serum iodine with each laboratory test serially obtained during the period of excretion of contrast medium failed to reveal any systematic effect. The data suggest that angiographic procedures and the levels of contrast medium utilized in infusion urography are safe even when applied to patients with liver or renal failure.Article HistoryAccepted: Apr 1969Published in print: Nov 1970 FiguresReferencesRelatedDetailsCited ByMagnetic Resonance Imaging Clinics of North America, Vol. 25, No. 4ISRN Radiology, Vol. 2013American Journal of Roentgenology, Vol. 171, No. 4Clinical Radiology, Vol. 41, No. 6The British Journal of Radiology, Vol. 58, No. 686Urologia Journal, Vol. 51, No. 2Urologia Journal, Vol. 49, No. 3Urologia Journal, Vol. 49, No. 4Kidney International, Vol. 18, No. 5Enzyme changes after coronary angiographyCardiovascular Radiology, Vol. 1, No. 3The American Journal of Medicine, Vol. 65, No. 1The British Journal of Radiology, Vol. 51, No. 607The British Journal of Radiology, Vol. 51, No. 607The American Journal of Medicine, Vol. 63, No. 6Excretory urography in acute and chronic renal failureUrology, Vol. 5, No. 3American Heart Journal, Vol. 90, No. 1New England Journal of Medicine, Vol. 291, No. 12Acta Radiologica. Diagnosis, Vol. 15, No. 1, Vol. 13 / 1Journal of Urology, Vol. 110, No. 1Radiologic Clinics of North America, Vol. 10, No. 3Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 97, No. 2 Metrics Altmetric Score PDF download

Drip infusion urography in patients with renal disease : R. D. Ensor, E. Anderson and R. R. Robinson. J. Urol. 103:267–271 (March), 1970

Drip infusion urography in patients with renal disease : R. D. Ensor, E. Anderson and R. R. Robinson. J. Urol. 103:267–271 (March), 1970

The use of contrast media in the diagnosis of urinary tract abnormalities in the dog, with particular reference to infusion urography: a report of two cases.

The use of contrast media in the diagnosis of urinary tract abnormalities in the dog, with particular reference to infusion urography: a report of two cases.

Drip Infusion Urography in Patients with Renal Disease

Drip Infusion Urography in Patients with Renal Disease

Blood clearances of contrast material in patients with impaired renal function.

RECENT publications have documented the clearance rates from the blood of the currently used radiopaque materials (2, 3,5,8). The goal of this investigation was the determination of quality of the intravenous urogram versus the injected dose in normal subjects. The fate of the injection material in patients who were unable to clear this material normally has not been completely shown (8). In the past these patients were rarely injected with contrast medium, and therefore little interest was given to this problem. With the technic of infusion urography to demonstrate the urinary tract in renal failure, however, it became important to know the clearance of this material. It had been observed that in some of these patients the gallbladder and/or bowel were visualized, whereas in others neither the urinary tract nor the gastrointestinal tract was opacified (1, 4). To determine the handling of the contrast material by patients with impaired renal function, contrast levels were fo1lowed after infusion urography. Material Twenty-one cases of abnormal renal function constitute the basis of this study. The diseases included hydronephrosis, end-stage renovascular hypertension, membranous nephritis, glomerular nephritis, lupus nephritis, and renal failure of unknown cause (TABLE I). Technic Patients were injected with varying doses of contrast material: between 35 and 70 grams of iodine in the form of Renografin 60 or Hypaque 90. Blood samples were drawn prior to the examination, five minutes after completion of the injection, one hour after the injection, and at daily or weekly intervals, as the patient's condition permitted, following the injection. The purpose was to determine the time required to decrease the blood level by 50 per cent (T 1/2 of the contrast material). The levels of the contrast material were ascertained on the basis of serum iodine; isotopic methods were not used. Neither urine nor fecal collections were obtained to determine the percentage of contrast material excreted by these routes. No attempt was made to separate protein-and nonprotein-bound iodine. Close observation of the patient's medications was made to exclude any extraneous iodine administration. The renal function tests used were the blood-urea nitrogen, the serum creatinine, and the creatinine clearance; serum-protein electrophoresis, urine specific gravity, urine 24-hour volume, urine-protein excretion, and serum-transaminase levels were also obtained. Complete testing was not carried out in all patients. Discussion The attenuation of blood levels of the currently used diatrizoate or iothalamate salts is well documented in the normal subject. In 80 per cent of the patients with normal renal function, a T 1/2 of less than sixty minutes is a common observation.

Renal Artery Infusion Urography

HomeRadiologyVol. 91, No. 2 PreviousNext Announcements and Book ReviewsLetters to the EditorRenal Artery Infusion UrographyW. S. C. HareW. S. C. HareW. S. C. HarePublished Online:Aug 1 1968https://doi.org/10.1148/91.2.398aMoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryPublished in print: Aug 1968 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 91, No. 2 Metrics Altmetric Score PDF download