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A seven-year-old male cat that was previously diagnosed with - and treated for - left hydronephrosis due to suspected idiopathic proteinaceous materials in the renal pelvis, presented with a short history of anorexia and vomiting. The abdominal ultrasound revealed bilateral hydronephrosis, and the intravenous pyelography showed a moderate amount of free fluid in the retroperitoneal space at 48 hours. After the nephrectomy, the gross examination of the right kidney revealed a very thin capsule with urine leakage, and the right renal pelvis showed small, black deposits. The histopathology of the right kidney revealed hydronephrosis with compression atrophy, necrosis of the renal cortex/medulla, and a moderate lymphoplasmacytic inflammation. The crystallographic analysis revealed that the black deposits were composed of 100% protein and no minerals. The cat was diagnosed with hydronephrosis and spontaneous renal rupture caused by proteinaceous pelvic materials, secondary to the idiopathic renal lymphoplasmacytic inflammation. In addition to revealing the possibility that immune-mediated renal disease can induce spontaneous renal rupture in cats, this case report demonstrates the utility of imaging for diagnosing and monitoring hydronephrosis, detecting urine leakage, and planning surgery.

Hutch diverticulum is a congenital diverticulum of the urinary bladder, reported infrequently in children and rare amongst adults. We present a 60-year-old male patient with bilateral Hutch diverticula, detected incidentally during an abdominal ultrasound examination performed for blunt abdominal trauma. This rare case highlights an unusual incidental presentation and opportunity to learn how to differentiate it from acquired bladder diverticula. The available treatment options are also discussed varying from simple follow-up to aggressive surgery.

Amaç: İntravenözpiyelografi İVP böbrek fonksiyonlarını ve anatomik özelliklerini gösteren bir yöntemdir. Fakat iyonizan radyasyon içermesi nedeniylepediatrik yaş grubunda kullanılması uygun değildir. Bu nedenle son zamanlarda kullanımı yaygınlaşan manyetik rezonansürografi MRÜ ile üriner patolojiler değerlendirilmeye çalışılmaktadır. Bizde çalışmamızda MRÜ’ninüriner sistem dilatasyonlarını göstermekte İVP ile arasındaki farkları incelemeyi amaçladık.Gereç ve Yöntem: Bu retrospektif çalışmada 40 pediatrik yaş grubundaki hastanın İVP ve MRÜ tetkikleri incelendi.Tetkikler arasındaki pelvikalisiyel sistem dilatasyon dereceleri karşılaştırıldı. Bulgular: MRÜ ile İVP arasında pelvikalisiyel sistem dilatasyon derecelerini saptama konusunda anlamlı farklılık izlenmedi P

Hutch diverticulum is a congenital diverticulum of the urinary bladder, reported infrequently in children and rare amongst adults. We present a 60-year-old male patient with bilateral Hutch diverticula, detected incidentally during an abdominal ultrasound examination performed for blunt abdominal trauma. This rare case highlights an unusual incidental presentation and opportunity to learn how to differentiate it from acquired bladder diverticula. The available treatment options are also discussed varying from simple follow-up to aggressive surgery. [ABSTRACT FROM AUTHOR]

Objective: The cervical cancer is the most found cancer in the gynecological malignancy. Several cervical cancer cases sometimes are found the result of Intravenous Pyelography examination that is not suitable with the clinical stage that has been examined according to Federation Internationale de Gynecologie et d'Obstetrique. Another deviation that accompanies the cervical cancer cases is very important for clinicians and the patients because of the distinct deviation managements. The utilization of other modalities in supporting the other deviations needs to be considered so that the patient service will be better and more accurate as it is expected by the clinicians and the patients. Aim: This study aims to identify comorbid abnormalities in cervical cancer patients undergoing Intravenous Pyelography examinations and clinical examinations according to FIGO. Method: The retrospective research is applied from the medical records of the cervical cancer patients in stage IA IVB on January until December 2014 and it is analyzed statistically. Result: From 131 samples, it is obtained 77 samples which are qualified the inclusion criteria. There are 48 samples (62,3%) which are resulted to normal IVP and 29 abnormal samples (37,7%). It is also revealed that there are comorbidity deviation in 14 patients (18,2%). Conclusion: From the result of intravenous pyelography examination, it is found that several comorbidity deviations based on the result of BUN/creatinine and clinical examination of Federation Internationale de Gynecologie et d'Obstetrique should not be found any deviation. Regarding these results, the clinicians therefore can consider the next management for the patients. [ABSTRACT FROM AUTHOR]

Objective: Intravenous pyelography (IVP) is a method of showing renal functions and anatomical features. However, it is not appropriate to use it in the pediatric age group because of ionizing radiation. For this reason, we are trying to evaluate urinary pathologies with magnetic resonance urography (MRU), which has become popular in recent years. In our study, we aimed to investigate the differences between MRU and IVU, showing dilution of urinary system. Materials and Methods: Male and female rats were administered with L-thyroxine intraperitoneally at a dose of 0.2 mg/kg for 21 days to induce hyperthyroidism. Morris water maze (MWM) was used to assess learning and memory performance. Results: There was no significant difference in the detection of pelvicalyceal dilatation between MRU and IVP (P <0.0001). MRU was found to be effective in evaluating parenchymal pathologies and in determining the underlying pathologies in patients with no nephrogram phase in IVP. Conclusion: There was no significant difference in the detection of pelvicalyceal dilatation between MRU and IVP (P <0.0001). MRU was found to be effective in evaluating parenchymal pathologies and in determining the underlying pathologies in patients with no nephrogram phase in IVP. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the accuracy of triple-bolus computed tomography urography (CTU) as a surrogate of intravenous pyelography (IVP) for determining the anatomy of the urinary collecting system in living kidney donors. Materials and Methods: In an analytic descriptive cross-sectional study, 36 healthy kidney donors were recruited during 12 months. Preoperative IVP and CTU were utilized to evaluate kidneys' anatomy; major and minor calyces and variation were used as anatomical indices to compare the accuracy of CTU and IVP; the images were then compared to surgical findings. Results: Thirty-six kidney donors (92% male; mean age: 28 ± 6 years) were enrolled in this study. The kappa coefficient value was significant and almost perfect for the CTU and IVP findings in detecting the pattern of calyces (kappa coefficient 0.92, asymptotic 95% confidence interval 0.86-0.97). Anatomic variations or anomalies of the urinary collecting system included the bifid pelvis (5.6%), duplication (8.3%), and extra-renal pelvis (2.8%). Both the sensitivity and specificity of CTU in the detection of the anatomy and variations were 100%; the sensitivity and specificity of IVP were 83.3% and 100%, respectively. Conclusions: The triple-bolus preoperative CTU can be considered an alternative to IVP for assessing the anatomy of the urinary collecting system. [ABSTRACT FROM AUTHOR]

Purpose: The standard treatment for a duplex kidney with poorly functioning upper pole moiety is ipsilateral upper pole heminephrectomy. This procedure is usually performed by open surgery, but with recent developments in techniques of uro-laparoscopy, it can be done with it, safely. In this study we evaluated the results and safety of laparoscopic heminephrectomy in our consecutive cases.Materials and Methods: From February 2001 to May 2007 fourteen unilateral laparoscopic heminephrectomy were performed in our center. Patients' characteristics, presenting symptoms, operative time, and blood loss, early and late complications were all collected retrospectively. Using pre-operative ultrasonography, intravenous pyelography (IVP) and CT scanning, unilateral upper pole hydronephrosis was detected in all cases. By DMSA isotope scan hypofunctioning of ipsilateral moieties was detected in all cases.Results: Mean operative time was 203±80 minutes. No major intra-operative or early complications were identified. Mean hospital stay was 4.1 days. On mean follow-up of 32 months no disturbing symptoms or episodes of urinary tract infections (UTIs) were detected. Atrophic kidney was detected in one case in post-operative IVP.Conclusion: Laparoscopic heminephrectomy is a valuable minimal invasive procedure that can be performed safely in experienced hands without any important complication. Perfect renal pedicles vascular system manipulation is important for the preservation of renal function post-operatively.

Objective: This study aimed to evaluate the sensitivity and specificity of radiological diagnostic methods, urinary biomarkers and urine cytology for patients with microscopic hematuria in the diagnosis of bladder cancer. Materials and methods: A total of 150 patients with the initial diagnosis of microscopic hematuria were included in the study. Patients were prospectively evaluated in terms of urinary symptomatology, physical examination, smoking habits, intravenous pyelography (IVP), abdominal ultrasonography (USG), Nuclear Matrix Protein 22 (NMP22), urine cytology and NMP22 BladderChek® test. The cut-off point for NMP22 test was accepted as 10 U/mL. Results: Mean age of the study population was 49.8±10.79 years with a male to female ratio of 1.08 (78/72). Overall, 10.7% (n=16) of patients had pathological diagnosis of bladder cancer, whereas 89.5% of the study population had no etiology for microhematuria. IVP was considered as the most sensitive and specific test in the diagnosis of bladder cancer. However, voided urine cytology was the least sensitive test, although it has the same specificity with IVP. The best sensitivity and specificity values were demonstrated when NMP22 and abdominal USG were used in double-test combinations. Conclusion: In microscopic hematuria, the combination of radiological methods with tumor markers such as NMP22 BladderChek® test, provides 100% sensitivity, and protects nearly half of cases from unnecessary cystoscopies. [ABSTRACT FROM AUTHOR]

To assess the role of routine intravenous pyelography (IVP), rectoscopy and additional imaging techniques like computed tomography (CT) and abdominal ultrasonography (USG) for the evaluation of patients with endometrial cancer. A total of 97 women with endometrial cancer (82 endometrioid and 15 non-endometrioid type) of all stages (Stage I = 65, II = 14, III = 13, IV = 5) were included in the study. Of these, 50 women were admitted because of postmenopausal bleeding, 24 with irregular vaginal bleeding and 7 with pain and leucorrhea, whereas the others had no complaints. Only one patient had symptoms related to the gastrointestinal system, but none for the urinary system. Preoperative CT ( n = 45), IVP ( n = 78), rectoscopy ( n = 46), and USG or colonoscopy ( n = 37) were performed on our patients. All the women had total abdominal hysterectomy and bilateral salpingo-oophorectomy, with/without pelvic ( n = 81) and paraaortic ( n = 34) lymphonodectomy, and omentectomy ( n = 35). In 39 of 45 women who had CT, it had no effect on the operation and did not facilitate the operation. In two women there were pathological findings on CT and some interventions (resection and anastomosis) were performed on the gastrointestinal tract in these patients. However, CT had overcome pathological findings related with the gastrointestinal or urinary systems in four women, who needed interventions to these systems during the operation. CT was not performed on six women who needed interventions to the gastrointestinal system during the operations. Three patients had pathological findings (fissure, external compression) in rectoscopy, but only one patient had ileo-transverstomy, in which rectoscopic finding had not predicted the necessity of that procedure. Out of 78 IVP, the only finding was external compression to the bladder in 38 patients, and this finding had no contribution to the operation. Among women who had USG or colonoscopy ( n = 37) performed, five had pathological findings that contributed to the extensiveness or the mode of the operations (liver nodules, polyps in the colon). Routine preoperative computed tomography, intravenous pyelography, rectoscopy or abdominal USG and colonoscopy have little impact on the decision and the prediction of the extensiveness of the operation. [ABSTRACT FROM AUTHOR]

Background. Nephropathy associated with contrast medium exposure is a well-known complication of IVP. However, it is uncertain whether iso-osmolar non-iodinated contrast medium (iodixanol) is less nephrotoxic than low-osmolar contrast medium (iohexol). Materials and Methods. In this single-center, double-blind, prospective study, 50 patients undergoing IVP were randomized into two groups receiving different contrast medium: iodixanol and iohexol. Patients in high risk for contrast nephropathy were included, 28 with renal insufficiency and 19 with diabetes mellitus. We compared the nephrotoxic effect (contrast nephropathy), complement and cytokines profile between the iodixanol and iohexol groups. The mean volume of contrast medium in each IVP procedure was 0.8 mL/kg. Results. The incidence of contrast nephropathy was 4 percent among all patients (one iodixanol and one iohexol). We found no significant differences in contrast nephropathy and allergic reactions between the two groups. There was no significant difference in cytokine profiles in both groups (p > 0.05).The incidence of allergic reaction was 16 percent among all patients. Twelve percent (3/25) had late reaction after iohexol exposure compared to four percent (2/25) with iodixanol (p = 1.0). One patient had severe skin rash due to late adverse reaction after iodixanol. No mortality was found. Conclusions. New iodixanol and iohexol contrast medium for routine IVP examination are safe and have low nephrotoxicity profile, especially in elderly or high-risk patients. Iodixanol contrast medium has an increased risk to induce severe late adverse reaction compared to iohexol. Allergic reaction may be the main adverse effect after contrast medium infusion. [ABSTRACT FROM AUTHOR]

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Objectives To report the diagnosis and outcome after surgical correction of bilateral distal ureteral anomalies in a Standardbred filly. Study Design Clinical case report. Animal An 8-month-old, 310 kg Standardbred filly with left ureteral atresia and right ureteral ectopia. Methods The filly was admitted for evaluation of incontinence since birth and severe urine scalding of the hindquarters. Diagnosis was made by both direct (cystoscopy and vaginoscopy) and indirect (intravenous pyelography, ultrasonography, and scintigraphy) evaluation of the ureters and bladder. The filly had left ureteral atresia, hydronephrosis, and decreased left-sided renal function and right ureteral ectopia before surgery. Surgical correction was performed on the left by an end-to-side stapled anastomosis technique and on the right by a side-to-side hand-sewn anastomosis technique. Results Surgical correction was successful. The filly had no postoperative complications and remained continent 18 months after surgery. Left renal function improved. Conclusion Ureteral anomalies can be successfully repaired in larger (>300 kg) foals and some renal function may be restored after surgical correction. Clinical Relevance Scintigraphy should be considered in diagnosis of ureteral anomalies, assessing renal function, and determining prognosis for horses with hydronephrosis caused by ureteral ectopia and atresia. [ABSTRACT FROM AUTHOR]

Abstract Objectives: 1. To investigate the diagnostic accuracy of urinalysis and the plain abdominal radiograph in predicting positive intravenous pyelography for patients with a history and examination suggestive of ureteric colic. 2. To examine the disposition of patients presenting to the emergency department with ureteric colic. Methods: A retrospective cohort study set in a tertiary referral hospital emergency department over a 12-month period was conducted. Three hundred and eighteen patients who presented with a provisional diagnosis of ureteric colic and had intravenous pyelography were identified from radiology department logs and emergency department discharge International Classification of Disease-9 codes. Results: Three hundred and eighteen patients were identified. Sixty-nine per cent had positive intravenous pyelography. Sensitivity and specificity of: urinalysis were 93% and 41%; abdominal X-ray, 57% and 83%; and urinalysis plus abdominal X-ray, 99% and 36%, respectively. Seventy-seven per cent were admitted to the emergency department observation ward. Twenty-seven per cent were subsequently admitted under the hospital’s urology service. Conclusions: Sex, haematuria and the presence of a calculus on abdominal X-ray were all significant predictors of positive intravenous pyelography. Haematuria was sensitive but not specific for positive intravenous pyelography. The addition of the abdominal X-ray marginally improves the diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Background: Contrast nephropathy is a common and often reversible cause of acute renal failure (ARF). About 10% of ARF in admitted patients might be due to it and may also lead to dialysis. Some methods could prevent it such as fluid therapy with half or normal saline, Na bicarbonate, N-acetyl cysteine (NAC), and so on. The aim of this study was to evaluate the efficacy of NAC to prevent contrast nephropathy. Materials and Methods: In a cross-sectional study, 110 patients who were candidate for intravenous pyelography (IVP) or CT scan enrolled in two groups: Case and control. In patients of case group, meglumine compound and in control group, placebo was prescribed before procedure. Before study and after 48 h, blood urea nitrogen (BUN) and creatinine (Cr) was checked, and glomerular filtration rate (GFR) was measured with Cockcroft-Gault formula. Results: There were no difference between age and gender of two groups. There was also no significant difference between mean Cr before and after study; however, GFR of patients in case group was significantly higher than the control group after 48 h of procedure. Conclusion: Because GFR was higher in case group and there were no drug side-effects in patients, we recommend the use of NAC before administration of intravenous contrast especially in high-risk population such as diabetic patients.

The diagnostic value of cystoscopy and intravenous pyelography in the staging of carcinoma of the corpus uteri was evaluated in a retrospective study of 218 patients. The primary treatment in all patients was surgical. Cystoscopy was performed preoperatively in 71 (33%) of the patients and postoperatively in 90 (41%); 57 (26%) patients were not subjected to this investigation. Intravenous pyelography was performed in 95 (44%) of the patients and postoperatively in 70 (32%); 53 (24%) patients were not subjected to this investigation. In no patient did cystoscopy reveal invasion of the bladder by tumor. In one patient with a stromal sarcoma (stage IV), there was no flow of dye through the ureteral orifices. Intravenous pyelography revealed unilateral ureteral obstruction in one case of stromal sarcoma (stage III) and complete bilateral ureteral obstruction in another case (stage IV). These findings show that cystoscopy and intravenous pyelography are unnecessary in carcinoma of the corpus uteri at stages I and II, and that in stages III and IV the necessity for these investigations should be considered for each patient on an individual basis. [ABSTRACT FROM AUTHOR]

Four boys, each with urethral obstruction caused by a prolapsed simple ureterocele (from a non-duplicated collecting system) are reported. This is an unusual complication of an uncommon anomaly. [ABSTRACT FROM AUTHOR]

The urograms of 186 boys and 145 girls were scrutinized in order to reveal the incidence of ureteral jets demonstrable during intravenous pyelography (IVP). In this series a unilateral jet was observed in 26 cases and a bilateral jet in 6 cases. Ureteral jets were almost three times as common in patients with normal urograms compared with those revealing urinary abnormalities. The incidence of a positive jet sign, usually unilateral, varies with the employed technique of examination, but the highest incidence in routine IVP seems to be about 30%. Although infrequent, significant ipsilateral vesicoureteral reflux (VUR) may occur. This fact together with the reported low rate of bilateral jets restricts the value of uneteral jets being used as an indicator of absence of gross VUR. The need for micturition cysto-urethography (MCU) at the uro-radiological work-up remains unchallenged. [ABSTRACT FROM AUTHOR]

A randomized, double-blind clinical trial was performed to compare a higher dose of conventional ionic contrast media (diatrizoate) with a lower dose of a new, nonionic contrast material (ioversol) for excretory urography (EU). One hundred twenty patients were randomized to receive either 100 ml of diatrizoate (Renografin-60) or 75 ml of ioversol (Optiray-320). Despite the lower iodine dose, the use of ioversol resulted in significantly better opacification of the calyces, renal pelves, and ureters. There was no significant difference in renal parenchymal opacification, opacification of the urinary bladder, or distention of the collecting system. We conclude that high-quality EU can be performed with a lower iodine dose using ioversol. [ABSTRACT FROM AUTHOR]

A group of women with carcinoma of the cervix was studied by renography and i.v. pyelography. The incidence of renal and urinary tract disorders detected by these tests increased as did the stage of the disease, being 17.1% with Stage I carcinoma of the cervix, 27.8% with Stage II carcinoma of the cervix, 47% with Stage III carcinoma of the cervix, and 83.3% in Stage IV carcinoma of the cervix. In patients with Stage I and Stage II carcinoma of the cervix, those selected for radiotherapy had twice the incidence of abnormal renograms as those selected for surgery. This difference probably reflected a higher incidence of medical disorders affecting renal and urinary tract function in those considered unfit for surgery. We believe that renograms should be used routinely as a screening test in patients with carcinoma of the cervix. [ABSTRACT FROM AUTHOR]

Objective: To determine: 1) whether a simple clinical prediction rule could identify emergency department patients with ureteral calculi; 2) whether the kidney, ureter, and bladder (KUB) radiograph provides diagnostic information beyond that obtained from the history and physical examination; and 3) whether ureteral calculi can be diagnosed accurately in the emergency department without emergency excretory urography, commonly known as intravenous pyelography (IVP).Patients: Two hundred three patients who underwent emergency KUB and IVP studies for nontraumatic abdominal or flank pain (derivation group) were retrospectively identified from radiology department records; 72 patients were prospectively evaluated in the emergency department for suspected ureteral stones (validation group).Measurements: Clinical information included age, gender, characteristics of pain, associated symptoms, presence of fever, history of ureteral calculi, whether a stone was passed, and results of urinalysis and KUB and IVP studies. All KUB and IVP radiographs were independently reviewed by a radiologist blinded to the patient's clinical information and urinalysis results.Design: Stepwise linear discriminant analysis was used to derive a four-item prediction rule from the derivation group and the validation group; the areas under the receiver operating characteristic (ROC) curves and the misclassification rates were compared.Results: The four-item rule (acute onset, flank pain, hematuria, and positive KUB radiograph) correctly classified 83% of patients in the derivation group and 90% in the validation group. The four-item rule had an ROC area of 0.86 in the derivation group and 0.89 in the validation group. The KUB radiograph significantly improved the discriminant ability of the two history items and the urinalysis result. Thirty-three percent of patients were identified to be in a subset with a 96% probability of having a stone.Conclusion: These findings, which should be confirmed in another emergency department, suggest that subsets of patients with suspected ureteral calculi may be managed without emergency IVP; this approach thereby reduces the time a patient spends in the emergency department, radiation exposure, expense, and morbidity. [ABSTRACT FROM AUTHOR]