title: The Whitaker test.
abstract: OBJECTIVE
  The Whitaker test was conceived and developed by Roger H. Whitaker (May 25, 1939) while he was a resident at Cambridge University in the late 1960s and early 1970s. The test combines a urodynamic study with antegrade pyelography to measure the pressure differential between the renal pelvis and the bladder. The test can differentiate between patients with residual or recurrent obstruction and those with dilatation secondary to permanent changes in the musculature.
  
  
  METHODS
  We present the history of the Whitaker test and its place in modern practice.
  
  
  RESULTS
  It is useful in evaluating patients with questionable ureteropelvic or ureterovesical junction obstruction and primary defects in the ureteral musculature. It can also be used to determine when percutaneous nephrostomy tubes can be safely discontinued in postoperative patients.
  
  
  CONCLUSIONS
  The merit of the Whitaker test in comparison to other less invasive tests, specifically diuretic renography, is the subject of much debate. However, such debate erroneously presupposes that the tests are directly comparable, which they are not. The correct use for the Whitaker test is to assesses potential upper tract obstruction in equivocal cases and should only be utilized when equivocal results are obtained by other less invasive tests, obstruction is suspected in a poorly functioning kidney, a negative renogram with colic, intermittent obstruction, and percutaneous access already exists and the cause of dilatation needs investigating.
authors.affiliation: Department of Urology, Virginia Mason Medical Center, 1100 Ninth Ave C7-URO, Seattle, Washington 98101, USA. richard.b.johnston@gmail.com.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Johnston
authors.affiliation: Virginia Mason Medical Center, Seattle, WA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Porter
mesh_terms: D003950:Diagnostic Techniques, Urological / Q000266:history*; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000503:physiopathology; D049673:History, 20th Century; D006801:Humans; D007682:Kidney Pelvis / Q000502:physiology; D011312:Pressure; D012008:Recurrence; D014517:Ureteral Obstruction / Q000175:diagnosis* / Q000266:history* / Q000503:physiopathology; D001743:Urinary Bladder / Q000502:physiology; D014563:Urodynamics; D014567:Urography