The Whitaker Test: Experimental Analysis in a Canine Model of Partial Ureteric Obstruction

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Abstract
The Whitaker test has been described as a means of reaching a diagnosis in equivocal upper urinary tract obstruction, but there has been conflicting evidence regarding the validity of this test. The present study assesses the reliability of the test in an experimental model which creates an accurate and predetermined degree of partial obstruction of the ureter. The Whitaker test was performed using the standard perfusion rate of 10 ml/min in male adult dogs using a long-term indwelling renal intrapelvic cannula before and after application of ureteric obstruction, and after one month. Control animals underwent a sham procedure. Results of in vivo and in vitro perfusion studies were compared. Perfusion studies at multiple flow rates were also performed. The Whitaker test reliably detected the presence of ureteric obstruction and the degree of partial obstruction could be determined. Multiple flow rate studies did not significantly improve test results. Provoked pressures in the highest grade of obstruction were less than expected and this may be due to pyelovenous reflux.