Administrators, Editors, Administrators
3,484
edits
Changes
Jump to navigation
Jump to search
+Grading
The procedure can be started in supine position. It can be done in a clean technique (not necessarily sterile) with gloves and radiation protection.
*Generally use low radiation dose fluoroscopy with normal dose single projections.
*Close any indwelling urinary bladder catheter in order to easier detect any contrast ending up in the bladder.
==Procedure with established nephrostomy==
[[File:Society for Fetal Urology (SFU) grading of hydronephrosis.jpg|thumb|150px|SFU grading of [[hydronephrosis]].]]
*Take an initial anteroposterior image including the presumed locations of the kidney, ureter and urinary bladder.
*Infuse iodinated contrast, usually at least a volume corresponding to about 15 ml of 240mg/ml iodine. Observe both the imaging and whether the patient develops flank pain. Optionally, note how much contrast has been infused at that point.
*Note the following:
:*Location of the tip of the catheter in the kidney
:*Any visible hydronephrosis or hydroureter. If present, also note:::*Severity of the hydronephrosis::*Any caliber change, or most distal part reached by contrast.
:*Any contrast outside the catheter or urinary tract, including leakage along the outside of the catheter
:*Flow into the urinary bladder (see below if none).
After the procedure, open up any closed bladder catheter.
===If contrast does not reach the urinary bladder===
*Catheter tip location
*Any visible hydronephrosis or hydroureter
:*If present, grading of any hydronephrosis
*Location of the most distal part reached by contrast, or caliber change
*Even absence of leakage
