Reflux and posterior urethra
The bladder is filled with warm contrast through a thin catheter until the urge, then the patient urinates under fluoroscopy control: the flow of contrast into the ureters is recorded and classified according to degrees I–V - the treatment of reflux depends on this (observation, endoscopic correction or reimplantation of the ureter); at the same time, the posterior urethra is visible, where valves in boys and narrowings after injuries and operations are revealed. The study is also informative in adults with neurogenic disorders. Requires sterile urine; after - drink plenty of fluids.
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.
