Radiology of urinary undiversion

Many patients with urinary diversions are now considered candidates for "undiversion". Radiographic evaluation prior to undiversion of the urinary tract includes cystography to determine bladder capacity and sensation, urinary continence, and the presence of reflux. Urography, loopography, and/or ureterography (antegrade and/or retrograde) are necessary to completely visualize the remaining urinary structures. Surgical techniques involved in the reconstruction are briefly discussed to facilitate an understanding of the often unusual radiographic appearance of the undiverted urinary tract. Stentograms and cystography are recommended for early postoperative evaluation to exclude urinary leakage or significant obstruction. Percutaneous ureteral perfusion studies are often useful in the long-term follow-up of these patients.