From Big Medical Encyclopedia

HROMOTsISTOSKOPYYa (Greek chroma color, coloring + a tsistoskopiya) — the method of a simultaneous separate research of function of kidneys and passability of upper uric ways consisting in intravenous administration of colorant of indigo carmine with the subsequent overseeing by its removal from mouths of ureters by means of the cystoscope.

Hromotsistoskopiya was implemented in a wedge, practice by Felker and Josef (F. Voelcker, E. Joseph) in 1903. It was preceded by pilot studies of R. Geyden-gayn (1874), Nussbaum (J. N. Nuss-baum, 1879), N. A. Hrzhonshchevsky (1864), V. K. Lingdemang (1896) who established that the indigosernokisly sodium entered into blood is emitted in not changed look with a tubule of nephron. Researches Aura-visto (To. J. Oravisto, 1957) it is established that 88 — 92% of the indigo carmine (see) entered into blood are allocated in urine with renal tubules, and pochechnykhm balls — only 8 — 12%.

Hromotsistoskopiya is used as an additional functional method of a research at surgical diseases of kidneys and upper uric ways, and also for differential diagnosis of renal colic with other acute diseases of abdominal organs.

As a contraindication to use of a method serve acute inflammatory diseases of an urethra, bladder, bodies of a scrotum, prostate. Hromotsistoskopiya is impracticable at the injury, cicatricial narrowing of an urethra, adenoma and a prostate cancer interfering introduction of the cystoscope, cicatricial wrinkling of a bladder with reduction of its capacity (less than 50 ml) at disturbance of the general and renal circulation (shock, a collapse), and also at a heavy renal and liver failure. Release of indigo carmine depends on a functional condition of the kidney, i.e. activity of its canalicular device, and a condition of renal blood circulation, and also on excretory and motor function of a pelvis and an ureter. Cooling of an organism, an anoxemia, pain, poisoning with various poisons interfere with timely excretion of indigo carmine. Nek-ry radiopaque substances (Cardiotrastum, Diodrastum, etc.) reduce the speed of removal of indigo carmine from an organism as these substances are also excreted by the canalicular device of kidneys. In this regard carrying out a hromotsistoskopiya after excretory urography or an angiography is undesirable.

The research is begun with a tsistoskopiya (see). After introduction of the cystoscope and survey of a bladder enter intravenously 2 — 5 ml of 0,4% of solution of indigo carmine or intramusculary — 15 ml and start overseeing by mouths of ureters. Overseeing with release of indigo carmine is begun with the estimated healthy party. At the same time the beak of the cystoscope shall be located as it is possible closer to the mouth of an ureter that allows to avoid false impression about release of indigo carmine at a pelting of the painted stream of urine from the opposite side. At normal function of kidneys and upper uric ways to a bladder the stream of urine which is intensively painted in blue color (arrives at intravenous administration

of drug — on 3 — the 5th minute, and at intramuscular introduction — on 8 — the 15th minute). Note intensity of coloring of urine, frequency of reductions of the mouth of an ureter, the nature of ejection of a stream of the painted urine.

If release of indigo carmine is absent, observation is continued at intravenous administration — 10 — 12 min., at intramuscular — 20 — 25 min.; after this term the result of a research is considered negative. It indicates oppression of function of a kidney or disturbance of urodynamic (see) upper uric ways that it can be caused, e.g., by stones of a kidney and an ureter, a nephrophthisis, a hydronephrosis, pyelonephritis, etc.

Complications of a hromotsistoskopiya are connected directly with disturbance of a technique of carrying out a tsistoskopiya (see).

Bibliography: Braytsevv. R. Funktsio

nalny ability of kidneys at their surgical diseases, M., 1913; Of y-t e l A. Ya. Lokhano-pochechnye refluxes and their clinical value, M., 1959; The Guide to clinical urology, under the editorship of A. Ya. Pytel, page 168, M., 1969;

Frumkina. P. Cystoscopic atlas, M., 1954; About of a v i s to K.

J. Inve stigations into the excretion mechanism of indigo carmine in normal human kidney, Helsinki, 1957; Urologie in Klinik und Praxis, hrsg. v. R. Hohenfellner u. E. J. Zingg, Bd. 1, S. 234, Stuttgart — N. Y., 1982; VoelckerF. u. Joseph E. Funktionelle Nierendiagnostik ohne Ureterenkatheter, Munch, med. Wschr., S. 2081, 1903. Yu. A. Pytel.