Stone control
Up to 80–90% of urinary stones (oxalates, phosphates) contain calcium and are visible on a survey image - the doctor notes the shadow of the stone relative to landmarks and, on repeated images, tracks the progress along the ureter during stone expulsion therapy or fragments after crushing (ESWL). Urate stones are not visible on the image - ultrasound and CT are used for them. The image also serves as the first phase of excretory urography. Proper bowel preparation is critical: gases and bowel contents can obscure the shadows of stones.
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.
