Patient Preparation
As per American Urological Association (AUA) guidelines, [5] any patient undergoing a procedure that involves manipulation of the ureter must receive prophylactic antibiotics. Fluoroquinolones and TMP-SMX are the drugs of choice. If these drugs are unavailable or cannot be used because of adverse reactions, aminoglycosides plus ampicillin, first-/second-generation cephalosporins may be used.
Anesthesia
Depending on the reason for performing retrograde pyelography, the patient is typically given general anesthesia.
Positioning
The dorsal lithotomy position is used.
Monitoring & Follow-up
Cystoscopy and retrograde pyelography are typically performed as outpatient procedures. Once the procedure is complete, the patient typically stays in the hospital for a few hours to ensure stability and to ensure that no complications have occurred.
-
Pyelovenous Backflow
-
Normal Ureteral Orifice
-
Open and Closed Ended Catheter
-
Duplicated Collecting System
-
Renal Pelvic Stone
-
Fibroepithelial Polyp on CT scan
-
Occlusion balloon catheter used to help obtain antegrade access into the kidney
-
Ureteropelvic Junction Obstruction
-
Rigid Cystoscope
-
Cone tipped catheter into the ureteral orifice during a retrograde pyelogram
-
Right Ureteral Stricture
-
Right retrograde pyelogram demonstrates large filling defect in midureter due to transitional cell carcinoma
-
Retrograde ureterogram reveals smooth narrowing and medial shift of the ureter due to Retroperitoneal Fibrosis
-
left proximal ureteral obstruction in a pt s/p gastric banding
