The diagnosis of vesico-ureteral reflux. Radiologic and nuclear medicine methods.

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.