The Diagnosis of Vesico-Ureteral Reflux

Abstract

Video voiding cystourethrography in 47 patients was compared to ^99mTc cystography performed suprapubically in 20 patients and ¹²³I Hippuran renocystography performed in 43 patients. The degrees of reflux were equally distributed through the grades. ^99mTc cystography was negative in 4 of 5 grade 2 refluxes and positive in 4 out of 5 grade 3–4 refluxes. Computerized dynamic tracings of the ¹²³I renocystography showed an activity level increase over the kidneys of more than 1% of the bladder activity level in 47 units, 18 were equivocal and 21 negative. Grade 2 and 3 reflux found on the video VCU was refound on the renocystography. 24 false positives were found. It is concluded that ^99mTc cystography performed as in our unit adds no further information to the diagnosis of reflux and that ¹²³I renocystography diagnosing the more severe degrees of reflux may be a future method of non-invasive reflux control.