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(99m)technetium-mercaptoacetyltriglycine scintigraphy with full bladder in patients with severe bladder dysfunction

Nagabhushan, N; Syed, R; Hoh, IM; Syed, I; Ell, PJ; Shah, PJR; Neild, GH; ... Bomanji, JB; + view all (2006) (99m)technetium-mercaptoacetyltriglycine scintigraphy with full bladder in patients with severe bladder dysfunction. J UROLOGY , 176 (4) 1481 - 1486. 10.1016/j.juro.2006.06.029.

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Abstract

Purpose: We evaluated (99m)technetium-mercaptoacetyltriglycine scintigraphy for detecting threshold bladder volume at which upper tract obstruction occurs in patients with bladder dysfunction.Materials and Methods: A total of 24 patients 19 to 74 years old with severe bladder dysfunction who underwent (99m)technetium-mercaptoacetyltriglycine scintigraphy and videocystometrogram in a 4-year period were selected for retrospective study. (99m)Technetium-mercaptoacetyltriglycine scintigraphy was done with a full bladder with a mean instilled volume of more than 850 ml saline. In patients in whom an obstructed renal outflow pattern was observed saline was drained at a rate of 100 ml every 5 minutes while dynamic imaging was performed. If results were abnormal, the study was repeated with an empty bladder. Differential function, parenchymal transit time index and outflow efficiency were calculated.Results: Of the 24 patients 15 had an obstructed outflow pattern with a full bladder, which was relieved at a bladder volume of less than 390 ml (median 300, range 250 to 600). Only 2 of these 15 patients had a normal vesical end filling pressure of less than 20 cm H2O. There was no obstruction in 9 patients, of whom 5 had increased vesical end filling pressures. Followup in patients who had normal tracer outflow on a full bladder showed no decrease in renal function, while a small decrease was seen in patients who had obstructed outflow on a full bladder.Conclusion: This novel, full bladder (99m)technetium-mercaptoacetyltriglycine scintigraphic technique provides the ability to detect bladder volumes at which obstructive outflow patterns develop in patients with severe bladder dysfunction.

Type: Article
Title: (99m)technetium-mercaptoacetyltriglycine scintigraphy with full bladder in patients with severe bladder dysfunction
DOI: 10.1016/j.juro.2006.06.029
Keywords: bladder, bladder neck obstruction, technetium Tc 99m mertiatide, radionuclide imaging, DIURESIS RENOGRAPHY, NEUROGENIC BLADDER, TRACT OBSTRUCTION, EMPTY BLADDER, CYSTOMETRY, COMPLICATIONS, PRESSURE, INJURY, FLOW
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Metabolism and Experi Therapeutics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: http://discovery.ucl.ac.uk/id/eprint/7712
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