URETERAL JET EXAMINATION BY COLOR DOPPLER ULTRASOUND VERSUS IVP FOR THE ASSESSMENT OF URETERAL PATENCY FOLLOWING PELVIC-SURGERY - A PILOT-STUDY

During the study period 228 women underwent major gynecological surger y in our department. Of these, 25 were selected for the study because of suspected post-operative ureteric obstruction. Post-operatively, bo th intravenous pyelography (IVP) and ureteric jet examination by the m eans of color Doppler ultrasound were performed in the study group. Th e aims were to exclude iatrogenic ureteric occlusion and to test the r eliability of ureteric jet examination with ultrasound, as compared wi th IVP, as a diag nostic test for ureteric obstruction. In 19 patients both IVP and jet examination were normal. In the remaining six patien ts, jet was negative either uni- or bi-laterally. Of these six, only t wo obstructions were diagnosed using IVP. This test was associated wit h a positive predictive value of 33.3%, negative predictive value of 1 00%, sensitivity of 100%, specificity of 88.6%, false negative of 0% a nd a false positive of 17.4%. It is concluded that the results suggest that color Doppler ultrasound may be a good screening test for ureter ic occlusion following pelvic surgery. Whenever a jet test is negative , further evaluation by IVP is required.