Antegrade pressure measurement as a diagnostic tool in modern pediatric urologyReport as inadecuate

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World Journal of Urology

, Volume 29, Issue 6, pp 737–741

First Online: 17 June 2011Received: 10 January 2011Accepted: 03 June 2011


IntroductionThe antegrade pressure measurement APM or perfusion pressure-flow test Whitaker test is a method of antegrade measurement of pressure in the upper urinary tract. In this study, we present the long-term follow-up results of APMs performed in our institution in the late 1980s and early 1990s to see whether the diagnostic decisions that were based on the outcomes of the test prove to be correct in the long term.

Materials and methodsWe conducted a retrospective study by searching our hospital’s electronic database. We found a total of 16 APMs performed between 1987 and 1995 10 boys, six girls; mean age 61 months.

ResultsIn nine cases, action was undertaken immediately after the APM had been performed; in seven cases, this was a surgical procedure re-implantation-re-calibration or pyeloplasty after obstruction was demonstrated. In two cases both postoperative after previous pyeloplasty, absence of obstruction was demonstrated and nephrostomy tubes were subsequently closed. In one case, this resulted in hydronephrosis that had to be treated with a new JJ stent. In all the seven cases in which no action was deemed necessary as a result of the outcome of the APM, long-term follow-up showed that intervention had indeed not been necessary.

ConclusionAlthough not often used anymore, the APM seems to be a safe and valuable diagnostic tool in the work up for possible urinary tract obstruction in children, especially in cases in which there is serious doubt concerning conservative watchful waiting.

KeywordsWhitaker test Antegrade pressure recording Antegrade pressure measurement UPJ stenosis UVJ stenosis AbbreviationsAPMAntegrade pressure recording

IVPIntravenous pyelography

MRIMagnetic resonance imaging

UPJUreteropelvic junction

UVJUreterovesical junction

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Author: Paul W. Veenboer - Tom P. V. M. de Jong


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