Control through nephrostomy
The contrast is gently introduced through the drainage without punctures or catheterization of the urethra; The images show whether the contrast passes freely through the ureter into the bladder (then the nephrostomy can be clamped and removed) or stops at the level of a stone, stricture, compression by a tumor - then the extent of the narrowing and tactics are determined: stenting, plastic surgery of the ureteropelvic segment, ureteroanastomosis. The study is performed on patients after puncture nephrostomy for hydronephrosis, purulent pyelonephritis, and urolithiasis. Administration is sterile, pressure is controlled to avoid pelvic-renal reflux.
Indications
- urolithiasis - overview image to control X-ray positive stones;
- hydronephrosis, anomalies of the kidneys and ureters - excretory urography;
- urethral stricture, urethral trauma - urethrography;
- vesicoureteral reflux, diverticula, neurogenic bladder - cystography;
- control of drainage and patency after operations (antegrade pyelography, fistulography).
Place of x-ray for diseases of the urinary system
Although MSCT has largely replaced classical urography, X-ray techniques remain indispensable where a functional and “dynamic” picture is needed with a lower dose: monitoring the passage of stones using a survey image, assessing the urethra during urination (voice cystourethrography is the only way to see reflux and the posterior urethra), checking drainages and anastomoses with contrast. The studies are performed by a urologist and a radiologist at the clinic in conjunction, so the images are immediately interpreted in the context of treatment.
