CT Imaging in Urology: Assessing Renal Hydronephrosis and Urinary Tract Issues

Q: CT Imaging in Urology: Assessing Renal Hydronephrosis and Urinary Tract Issues

Hello： 1) There is a limit to CT scans; depending on the different models, it usually requires a few millimeters or more to make a judgment. <br>If the scans are done at the same hospital, it is often possible to compare the images from two different times. <br>2) The urine test

Computed Tomography (CT) Imaging

Hello, Director Du! Thank you very much for your consultations.
Regarding the first question of case 178099, you may have misunderstood my intention.
My question is: since my renal edema is caused by external pressure from a mass at the iliac artery compressing the ureter, during annual CT follow-ups, will the imaging be able to detect any mass that may be enveloping the ureter by the iliac artery? (In case there is growth.)
Additionally, regarding case 177907 and the issue of frequent urination, on February 7, due to a slow referral, a urinalysis was performed, and the National Health Insurance quick translation showed RBC: 0-2, WBC: 10-19, and occult blood: +, leukocyte esterase: +3.
However, I feel that my frequent urination has improved significantly.
Since I have not yet returned to the urology department, do the above data indicate that there is still a urinary tract infection, or could there be other underlying causes?

Hsiu, 60~69 year old female. Ask Date: 2022/02/08

Dr. Du Shixi reply Urology

Hello: 1) There is a limit to CT scans; depending on the different models, it usually requires a few millimeters or more to make a judgment.
If the scans are done at the same hospital, it is often possible to compare the images from two different times.
2) The urine test result for 177907 still shows inflammation, and a follow-up appointment is necessary.
As for the cause, it is difficult to determine if there are other reasons besides a urinary tract infection.
Wishing you good health.

Reply Date: 2022/02/08

More Info

In addressing your questions regarding CT imaging in urology, particularly concerning renal hydronephrosis and urinary tract issues, it is essential to understand the capabilities and limitations of CT scans in evaluating these conditions.

1. CT Imaging and Ureteral Mass Detection: When it comes to assessing whether a mass surrounding the ureter, particularly one that may be encased by the iliac artery, can be detected on a CT scan, the answer is nuanced. CT imaging is quite effective at visualizing soft tissue structures and can identify masses that exert pressure on the ureter. However, the ability to detect an intraluminal mass (a mass within the ureter itself) depends on several factors, including the size of the mass and the specific imaging protocols used. Generally, a mass must be of a certain size (often several millimeters) to be reliably detected on CT scans. If the mass is small or if it is located in a part of the ureter that is not well visualized due to the surrounding anatomy, it may be missed.
In your case, if there is a concern about a mass affecting the ureter due to external compression from the iliac artery, a CT scan can provide valuable information. However, if there is suspicion of an intraluminal mass, additional imaging modalities such as a CT Urogram or even ureteroscopy may be warranted for a more definitive assessment. These methods allow for direct visualization of the ureter and can help in identifying any obstructive lesions.

2. Urinary Tract Infection and Frequency of Urination: Regarding your urinary symptoms and the lab results indicating the presence of white blood cells (WBCs) and red blood cells (RBCs) in your urine, it is important to interpret these findings in the context of your clinical symptoms. The presence of WBCs, especially in the range of 10-19, along with positive leukocyte esterase, typically suggests an inflammatory process, which could be indicative of a urinary tract infection (UTI). However, the improvement in your frequency of urination may suggest that the infection is resolving or that there may be other factors at play.

It is also crucial to consider that urinary frequency can be influenced by various factors beyond infection, including bladder irritability, interstitial cystitis, or even psychological factors. Given your lab results and the improvement in symptoms, it would be prudent to follow up with your urologist for further evaluation. They may recommend repeat urinalysis to monitor for persistent infection or consider additional diagnostic tests to rule out other underlying conditions.

In summary, while CT imaging is a powerful tool in the assessment of renal hydronephrosis and urinary tract issues, it has limitations in detecting small or intraluminal masses. Regular follow-up and comprehensive evaluation of urinary symptoms, including laboratory tests and possibly imaging, are essential for effective management. If you have ongoing concerns about your urinary health or the findings from your imaging studies, it is advisable to maintain open communication with your healthcare provider to ensure appropriate follow-up and treatment.

Similar Q&A

Understanding CT Imaging for Urological Conditions: Key Insights

Director Du: Hello, I am inquiring about case number 177786. I would like to ask you again: The CT/MRI diagnosis from 107/10 for renal hydronephrosis is described as follows: Note soft tissue lesion over the left iliac region with encasement of the left ureter and iliac artery, c...

Dr. Du Shixi reply Urology
Hello: 1) There are no masses on the CT scan; this type of endoscopy is more detailed. 2) When visiting a hospital, major hospitals typically provide reports if there are abnormalities in other areas. Wishing you good health.

Managing Chronic Urinary Tract Infections and Kidney Hydronephrosis

Hello Doctor, since the end of April when I first noticed blood in my urine, I visited a general clinic and was diagnosed with right-sided hydronephrosis (ultrasound and X-ray did not reveal any stones at that time). I was advised to drink more water, and I started consuming over...

Dr. Du Shixi reply Urology
Hello: If you ask me to provide a reference, the relationship between urinary tract infections and hydronephrosis is minimal. It is essential to focus on treating the urinary tract infection; in addition to continuing medication, attention must be paid to lifestyle details. Some ...

Understanding Ureteral Reconstruction and Kidney Function Assessment

Hello, Dr. Hsu. I previously consulted you about the issue of "ureteral reimplantation," and I saw your response. Thank you! After being discharged, my follow-up appointment included an ultrasound, which revealed hydronephrosis in the left kidney (after the left urete...

Dr. Xu Weikai reply Urology
Hello, I'm not sure either. It might be the ratio of urine excretion from the two kidneys: one side at 42.7% and the other at 57.3% (just a guess). To determine if there is any swelling in the ureters, an ultrasound or an intravenous pyelogram (IVP) can be used. If there are...

Understanding Renal Hydronephrosis: Insights on Biopsy Results and Follow-Up

Hello, Director! In October 2018, a routine health check revealed renal hydronephrosis, leading to hospitalization at a teaching hospital for further examination, including IVU, abdominal CT, and MRI. It was determined that an extrinsic tumor was compressing the ureter. A needle ...

Dr. Du Shixi reply Urology
Hello: A biopsy is simply a procedure to obtain small tissue samples to assist in diagnosis. If no malignancy is detected, the usual approach is regular monitoring. However, it cannot be guaranteed that there is absolutely no malignancy, which is why continued follow-up is necess...