At present, primary megaureter is frequently diagnosed prenatally. The possibility of spontaneous recovery, in many cases, clearly indicates the need for a less invasive diagnostic procedure, able to give quantitative, standard data on the obstruction. This report concerns 43 children aged between 1 month and 11 years observed between January 1989 and October 1991. 52 ureters were affected. They were studied by urinary ultrasonography, voiding cystourethrogram, iv pyelography and by Tc 99m DTPA renography. Forty ureters were treated surgically and 12 ureters underwent conservative follow-up. A standardized renograpinc technique was employed: optimal hydratation by mouth and empty bladder during the test (trans-urethral catheter in children under 3 years of age) were considered important. Three renographic parameters were used: a) glomerular filtration rate (Gates method). b) Pyelo-ureteral transit with orthostatic and diuretic test (furosemide 0.5 mg/kg iv). c) Radio-tracer persistence in the ureteral region after orthostatic and diuretic test. The ureters were considered obstructed when the values of radiotracer clearance, after orthostatic and diuretic tests, were less than 20% in 10 min and if the ureteric images were present in all the scans. The comparison between traditional radiologic protocol and renographic results, showed good correspondence (χ2 = 13.68; p <0.001). Therefore, the diagnostic reliability of the Tc 99m DTPA scan associated with ultrasonography can, at least, be considered more selective than the iv pyelography, for the diagnosis of obstructive congenital megaureter and for the correct surgical indication, as it has been completely accepted for pelvic dilatation due to obstruction of the uretero-pelvic junction.
|Translated title of the contribution||Scintigraphic technique and parameters for the evaluation of obstructive congenital magaureter|
|Number of pages||4|
|Journal||Acta Urologica Italica|
|Issue number||SUPPL. 6|
|Publication status||Published - 1992|
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