These studies confirmed the presence of a persisting large left ureteral filling defect and a possible right distal filling defect, though his recent retrograde pyelogram
had been normal on May 11.
Caption: Figure 2: Retrograde pyelogram
image, showing a duplex collecting system in the right kidney and calyceal diverticulum connected to the upper renal calyx.
Caption: FIGURE 2: Retrograde pyelogram
of right kidney with filling defects throughout.
Three days later her hemoglobin was stable, and cystoscopy and left retrograde pyelogram
A left retrograde pyelogram
(RGP) showed gross upper pole caliectasis with pelvic staghorn calculus.
The retrograde pyelogram
confirmed the presence of the lesion, with evidence of obstruction in the mid ureter above the lesion (Figure 1).
Eight weeks postoperatively, the ureteral stent was removed and a retrograde pyelogram
was performed showing no extravasation, apparent healing of the UPJ, and mild hydronephrosis (Fig.
The patient was then scheduled for cystoscopy and bilateral retrograde pyelogram
. The procedure showed a blockage of the left ureter 5 cm superior to the bladder, and a patent right ureter.
Blaivas said that he finds a bilateral retrograde pyelogram
worthwhile even if it identifies one ureteral injury in 100 noninjured patients.
was performed and H shaped ureter was visualized.
Two of these patients were scheduled retrograde pyelogram
evaluation during re-look URS and the other two were followed using serial creatinine only.
The following tests can rule out obstruction:- 1) abdominal X-rays, 2) intravenous pyelogram (IVP), 3) retrograde pyelogram
, 4) ultrasound of the kidney, 5) abdominal CT scans and 6) MRI of the abdomen and kidneys.