Antegrade pyelography: a further look at an old technique

Fifty-five antegrade pyelograms have been carried out, and the indications for this investigation reviewed. Whilst an inadequate intravenous urogram together with a failed or impossible retrograde pyelogram remains the absolute indication for antegrade pyelography, we have also often bypassed the need for retrograde pyelography in our patients. This has been particularly rewarding in patients with recurrent urothelial tumours. We have also used the technique in other obstructive states, and combined it with functional measurements in the dilated ureter problems seen in childhood. We conclude that antegrade pyelography is a straightforward, safe and valuable investigation for the experienced clinico-radiological team.