“Stasis” — A test for vesico-ureteric orifice competence in children with reflux

Abstract

Intravenous radionuclide cystography (IVRNC) with one injection of 99m-Tc-DTPA measures renal function and detects vesico-renal reflux [1, 2,3]. This paper describes a possible means of detecting incompetent ureteric orifices during IVRNC examinations. In some patients a hold-up of material in the renal areas (stasis) was observed which suddenly cleared at micturition. A prospective study of 58 patients who had IVRNC and cystoscopy within 28 days of each other revealed that 76.3% had anatomically abnormal ureteric orifices on the same side as the stasis. This contrasted with only 12.8% of abnormal ureteric orfices found in patients not showing stasis (p<0.005). As incompetent ureteric orifices are recognised as the major aetiological factor in vesico-renal reflux [4, 5, 6] this additional information gained at IVRNC could be of clinical use and perhaps avoid some cystoscopies.