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There are many ways you can help children and their families get the care they need.
A Whitaker test is a minimally invasive, image guided treatment used to measure the pressures in the kidney and bladder to determine whether or not an obstruction exists in your child's urinary system. It detects subtle obstructions that cannot be detected by imaging or other means.
This test is performed by interventional radiologists who are highly trained to conduct this procedure on infants and children.
In addition to the interventional radiologist, your child will be treated by a team of anesthesiologists, nurse practitioners, nurses and technologists who specialize in caring for children undergoing interventional radiology procedures and treatments.
We perform Whitaker tests in the interventional radiology suite on the second floor of the hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia and examining rooms for outpatient visits.
Physicians recommend a Whitaker test for selected patients who have upper urinary tract dilation (enlargement), but in whom it is not clear if the condition is caused by a blockage. This test can help your child's physician determine if surgery is required.
If fluid is infused into the kidney faster than it can pass through a blockage, the pressure inside the kidney will rise and the pressure in the bladder will stay the same or fall.
In a Whitaker Test, the pressure inside both organs is measured at the same time, allowing the radiologist to detect even mild blockages. Antegrade pyelography, another interventional radiology procedure that visualizes contrast flowing from the kidney into the ureter and bladder, is an integral part of the Whitaker Test.
Explain to your child in simple terms why the treatment is needed and what will happen. You can say that you will be close by and that she may bring a favorite toy or blanket into the procedure room.
Someone from the hospital will call you a few days before the test to tell you where to go when you come to the hospital. The staff member will talk about when your child should stop eating, drinking and taking medicines.
When you arrive at the hospital for the procedure:
At the end of the procedure, the needle and catheter are removed and a small bandage is applied where the needle was inserted. Occasionally, in cases where significant obstruction is found, the radiologist will place an indwelling catheter (nephrostomy tube) in the kidney through the initial puncture site. This will allow urine to drain until your child's medical team can formulate a plan to treat the obstruction.
Your child will be taken to the recovery room, where we will closely monitor him. You may be with your child in the recovery room.
The interventional radiologist will speak with you after the procedure and explain the findings and results.
When performed by an appropriately trained and experienced interventional radiologist, the Whitaker test is safe. As the procedure is performed under general anesthesia, your child will feel no discomfort. There may be some mild discomfort at the puncture sites after the procedure.
During the Whitaker test, your child will be exposed to ionizing radiation (x-rays). While we always attempt to minimize exposure to x-rays, we believe that the benefit of an accurate diagnosis outweighs the exposure that occurs during the procedure. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”