[Antegrade pyelography].

Percutaneous antegrade pyelography under ultrasonic real-time guidance was performed in 18 cases of obstructive hydronephrosis, which were poorly visualized the renal collecting system on excretory urography and in which or retrograde pyelography could not be performed successfully. This technique was safe, accurate and easy, and provided significant diagnostic information in these cases. With the patient under local anesthesia an 18 gauge spinal needle was inserted into the renal pelvis. Approximately 10-20 ml fluid were withdrawn from the renal pelvis for cytology and culture. After the injection of contrast medium radiograms were obtained in adequate positions. Delayed films were obtained when indicated. In 8 cases pelvic and/or ureter tumor was diagnosed. In two cases congenital anomalies were diagnosed, one had complete obstruction at the ureteropelvic junction and the other had complete obstruction at the ureterovesical junction. In the other three cases ureter ligation and in 5 cases ureter stenosis were diagnosed. The quality of the aspirated urine was dark-red in 6 cases, positive cytology, in 6 cases, all of which had pelvic and/or ureter tumors. No severe complications were observed.