Additional benefits for MRU are in documenting active upper-tract infection versus scar formation to determine whether therapy has been effective in the high-risk patient. Radiography Abdomen Radiography of the abdomen has long been employed for the detection of calculi, intramural bladder wall calcification, gas in the wall or lumen of the urinary bladder, and/or foreign bodies that may be the etiology of a UTI. Use of digital tomosynthesis of the abdomen results in improved detection of urinary stones in general over digital radiography [51]. Bladder-wall calcification, when present, is typically due to prior infection with Schistosoma (uncommon in the United States, but very common in other parts of the world), tuberculosis, Cytoxan cystitis, or radiation cystitis [52]. For women with recurrent UTIs, however, abdominal radiography is generally not a useful diagnostic tool as other imaging modalities have higher sensitivity and specificity in this setting. Recurrent Lower Urinary Tract Infections in Females Radiography Intravenous Urography CT and MRU have supplanted the use of IVU for evaluation of urinary abnormalities at most institutions [27], and it is generally not useful for women with recurrent complicated UTIs. US Kidneys and Bladder Retroperitoneal US may be useful in women with recurrent UTIs, particularly prior to pregnancy, to evaluate for hydronephrosis and risk factors for recurrent infection. Hydronephrosis can be demonstrated as an indication of obstruction, although US may not yield a specific etiology [53-55]. US is a useful initial screening tool for obstructive uropathy and for postvoid residual volume determination to detect incomplete bladder emptying [56]. It should be noted, although US can detect renal stones, it is generally less sensitive than CT [57-59]. Renal abscess or perinephric collections can also be detected sonographically, and US of the bladder can be employed to evaluate for bladder diverticula detection [45].
Recurrent Lower Urinary Tract Infections in Females. Additional benefits for MRU are in documenting active upper-tract infection versus scar formation to determine whether therapy has been effective in the high-risk patient. Radiography Abdomen Radiography of the abdomen has long been employed for the detection of calculi, intramural bladder wall calcification, gas in the wall or lumen of the urinary bladder, and/or foreign bodies that may be the etiology of a UTI. Use of digital tomosynthesis of the abdomen results in improved detection of urinary stones in general over digital radiography [51]. Bladder-wall calcification, when present, is typically due to prior infection with Schistosoma (uncommon in the United States, but very common in other parts of the world), tuberculosis, Cytoxan cystitis, or radiation cystitis [52]. For women with recurrent UTIs, however, abdominal radiography is generally not a useful diagnostic tool as other imaging modalities have higher sensitivity and specificity in this setting. Recurrent Lower Urinary Tract Infections in Females Radiography Intravenous Urography CT and MRU have supplanted the use of IVU for evaluation of urinary abnormalities at most institutions [27], and it is generally not useful for women with recurrent complicated UTIs. US Kidneys and Bladder Retroperitoneal US may be useful in women with recurrent UTIs, particularly prior to pregnancy, to evaluate for hydronephrosis and risk factors for recurrent infection. Hydronephrosis can be demonstrated as an indication of obstruction, although US may not yield a specific etiology [53-55]. US is a useful initial screening tool for obstructive uropathy and for postvoid residual volume determination to detect incomplete bladder emptying [56]. It should be noted, although US can detect renal stones, it is generally less sensitive than CT [57-59]. Renal abscess or perinephric collections can also be detected sonographically, and US of the bladder can be employed to evaluate for bladder diverticula detection [45].