Idiopathic Hydronephrosis-The Diuresis Renogram: A New Non-Invasive Method of Assessing Equivocal Pelvioureteral Junction Obstruction

Abstract

A method to evaluate patients with equivocal obstruction of the pelvioureteral junction is described. It involves the performance of a standard 131I-heppuran renogram followed by a 2nd renogram 3 min after an i.v. injection of the diuretic, furosemide. When the 2 results are inspected together, the patients can be separated into 4 groups: normal, obstructed atonic and partially obstructed. The results in 23 children and 27 adults with suspected obstruction of the pelvioureteral junction are presented. Obstruction was confirmed in 18 patients and excluded in 32. The correlation between the renogram results and clinical, radiological and operative findings is discussed. The technique is simple, accurate and non-invasive, and it is recommended after excretory urography before proceeding to more invasive tests.