title: Antegrade pressure measurement as a diagnostic tool in modern pediatric urology.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  We 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).
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  Although 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.
authors.affiliation: Pediatric Renal Center, Department of Pediatric Urology, University Children's Hospital, UMCU, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands. p.w.veenboer@students.uu.nl
authors.forename: Paul W
authors.initials: PW
authors.lastname: Veenboer
authors.forename: Tom P V M
authors.initials: TP
authors.lastname: de Jong
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D011312:Pressure; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000175:diagnosis* / Q000503:physiopathology; D014551:Urinary Tract / Q000503:physiopathology*; D014572:Urology / Q000295:instrumentation / Q000379:methods / Q000639:trends