Paper Information

Title: 

COMPARISON OF DIURETIC SONOGRAPHY AND DURETIC RENAL SCAN IN DISTINCTION OF OBSTRUCTIVE AND NONOBSTRUCTIVE HYDRONEPHROSIS

Type: PAPER
Author(s): PIRANVISEH B.,NAROEINEJAD M.,REZAEEMEHR B.
 
 
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

PURPOSE A LARGE AMOUNT OF UROLOGIC PRACTICE IS EVALUATION OF URINARY TRACT OBSTRUCTION.
SONOGRAPHY IS A VALID PARACILINIC TEST FOR EVALUATING OF URINARY TRACT OBSTRACTION BUT IT CAN NOT DIFFERENTIATE OBSTRACTIVE HYDRONEPHROSIS FROM NON OBSTRACTIVE HYDRONEPHROSIS AND ONLY EVALATATE URINARY TRACT, FROM STATIC POINT OF VIEW.
BY INDUCING DIURESIS WE WANT TO EVALATATE THE DYNAMISM OF URINARY FLOW AND DIFFERENTIATE BETWEEN OBSTRACTIVE AND NON OBESTRACTIVE HYDRONEPHROSIS.
MATERIALS AND METHODS: 32 CASES WERE SELECTED FROM THE PATIENTS THAT WERE REFFERED FOR EVALUATING OF HYDRONEPHROSIS. INITIAL DIAGNOSIS IN THESE PATIENTS WERE UPJO.
PATIENTS WHIT BLADDER OUTLET OBSTRACTION, NEUROGENIC BLADDER VESICOURETERAL REFLUX AND RENAL FUNCTION IMPAIREMENT WERE EXCLUDED FROM THE STUDY TO ELIMINATE CONFOUNDING FACTOR.
DIURETIC ISOTOPE SCAN WERE DONE IN ALL OF THE PATIENTS. ANTERIOR-POSTERIOR DIAMETER OF THE RENAL PELVIS WERE MEASURED BEFOR AND 30 MINUTES AFTER DIURESIS (WITH 0.5 MG/KG FUROSEMIDE ADMINISTERED IV AND ORAL INTAKE OF 1500 CC WATER).
ON THE BASE OF MEOLA’S STUDY, OBSTRUCTION WERE DEFINED AS INCREASING OF APD OF RENAL PELVIS GREATER THAN SEVEN MILIMETRS AFTER DIURESIS.
THEN RESULTS OF DIURETIC SONOGRAPHY AND DIURETIC ISOTOPE SCAN WERE COMPARED.
RESULTS: 63 RENAL UNITES IN THE 32 PATIENTS WERE EVALUATED WITH DIURETIC SONOGRAPHY AND DIURETIC ISOTOP SCAN.
IN THE INITIAL SONOGRAPHIC EVALUATION 50.79% OF KIDNEYS WERE HYDRONEPHROTIC, THERE FOR WERE CONSIDERED OBSTRACTIVE.
CONSIDERING THE DIURETIC ISOTOPE SCAN AS AN ACCEPTED METHOD IN DIAGNOSING OBSTRUCTION, 63.6% OF EVALUATED UNITES WERE NON OBESTRACTIV.
THE RESULTS OF DIURETIC ISOTOP SCAN IN 9.6% OF KINEYS WERE EQUIVOCAL AND IN 23.4% OF KIDNEYS WERE OBESTRUATIVE.
REPATING SONOGRAPHIC EVALUATION AFTER DIURESIS, 71.9% OF KINDNEYS WERE NON OBESTRACTIVE AND 26.6% OF KIDNEYS WERE OBESTRATIVE.
ONE PATIENT HAD HORSE-SHOE KIDNEY AND ONE PATIENT HAD A MALROTED KIDNEY. RESULTS OF DIURETIC SONOGRAPHY AND DIURETIC ISOTOPE SCAN WERE NOT COMPATIBLE IN THESE PATIENTS.
CONCLUSIONS: URETIC SONOGRAPHY IN COMPARISON WITH DIURETIC ISOTOPE SCAN CAN DIFFERENTIATE OBSTRAETIVE HYDRONEPHROSIS FROM NON OBSTRUCTIVE HYDRONEPHROSIS WITH SENSITIVITY OF 93.33% AND SPECIFICITY OF 94.85%.
WE CAN USE THIS METHOD AS INITIAL EVAIUATION IN THE SUSPECTED URINARY TRUCT OBSTRACTION. ALSO DIURETIC SONOGRAPHY CAN BE USEFUL TOOL IN FOLLOW-UP OF PATENTS.
WE DON’T RECOMMEND THIS METHOD IN MALROTATED KIDNEYS.

 
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