[The Whitaker perfusion test in the diagnosis of organic obstruction of the upper urinary tract].

The X-ray and radioisotopic tools currently used in the diagnosis of upper urinary obstruction fail to take into account the dynamics of the ureter and largely depend on preserved renal function. Therefore Whitaker's test was proposed for this, which involves fluid perfusion along the nephrostomic drain and measurement of intrapelvic pressure. The test was employed in 40 patients and confirmed antegrade pyeloureterographic evidence in 32 (80%) patients, but failed in 8 (20%) patients who were suspected for upper urinary obstruction as shown by anterograde pyeloureterographic findings, whereas the perfusion test excluded the obstruction. The test provided evidence for the obstruction in 6 out of 26 cases, though antegrade pyeloureterography indicated as if the patency of the upper urinary tract were good. The results of Whitaker's test were supported by further clinical examinations and treatment of the patients. Two clinical cases are presented in the paper. It is concluded that Whitaker's perfusion test yields more accurate and objective data on the presence of organic obstruction of the upper urinary tract than do radioisotopic and X-ray tools. So the authors consider it advisable to apply it especially when it is questioned whether the obstruction is present or absent, as well as in patients undergone upper urinary plastic operations.