PYELO-CYSTOURETHROGRAPHY: METHODOLOGY

Children who require roentgen evaluation of the urinary tract need examination of the entire tract, which is accomplished with a cystourethrogram and an intravenous pyelogram. Cystourethrography yields a higher incidence of pathology than intravenous pyelography, but the procedures are complementary to each other. Intravenous pyelography, which examines the upper urinary tract, includes a large volume dosage of contrast agent, double injection, fluoroscopy, and multiple films during peak excretion, all applied according to the needs of the individual patient. Cystourethrography evaluates the lower urinary tract and utilizes nonirritating contrast agents, fluoroscopy, and sequential spot-films. Retrograde pyelography is indicated only when the collecting system is not visualized by either the intravenous pyelogram or refluxing cystogram. Fluoroscopy and multiple spotfilms assure accuracy in detection and documentation of pathology. Total body opacification is helpful in evaluating abdominal masses of small infants.