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January 31, 1972

Bladder Filling Maneuver For Visualization of Calculus in Lower Ureter

Author Affiliations

Walnut Creek, Calif

JAMA. 1972;219(5):621. doi:10.1001/jama.1972.03190310047019

To the Editor.—  After a urinary tract calculus has been demonstrated by excretory urography, its progress along the ureteral lumen must be observed by periodic roentgenographic studies. When the stone is not demonstrated in the lower part of the ureter, one must decide whether it has been passed or is still present. Before transurethral extraction or ureterolithotomy, one must visualize the stone roentgenographically in order to plan the approach.However, a calculus in the pelvic portion of the ureter, especially if it is small, of low radiodensity, or both, is often hard to demonstrate roentgenographically because of gas and feces in the intestinal tract. The simple maneuver described here shifts the bowel out of the pelvis and permits clear visualization of this portion of the ureter.

Method.—  The bladder is filled to capacity with sterile water through a urethral Foley catheter or through the cystoscope at the time of cystoscopic