[Urokinetography in the diagnosis and follow-up of obstructive uropathy in children].

Abstract

With regard to different paediatric urological diseases nuclear-medical urokinetography using the tracer 99m-Tc-DTPA can identify typical functional patterns. By means of 261 investigations on 240 children, retroperistaltic waves, initial pyeloureteral and the final ureterovesical conus, dysperistaltic waves and interrupting empty strips with lacing, constrictive peristalsis can be shown in comparison with the normal anterograde "stair" pattern. Moreover, UKG as a functional method makes it possible to control the therapeutic success of antibiotics in urinary inflammations, the situation after stone discharges and application of vegetative systemic drugs. In our opinion the operative procedure and the prognosis of megaureters can be assessed. Consequently urokinetography is among the important preoperative investigations in paediatric urology and in the follow-up programme after reconstructive urological operations. Nuclear-medical isotope investigation is without significant risk and yields many diagnostic details. The method can be recommended for functional urological diagnosis in children or teenagers with high frequency of follow-up investigations or in patients with contrast medium allergy. Finally, ureter physiology can be checked in patients subjected to bone scintigraphy. Clinical research is possible via UKG without additional radiation exposure.