What position could be added to an intravenous urogram examination to promote better filling of the ureters with contrast medium following hydronephrosis?

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Adding the prone position during an intravenous urogram examination can help enhance the filling of the ureters with contrast medium following hydronephrosis because this position allows better gravitational effect on the urinary system. When the patient is in a prone position, the abdominal organs, including the kidneys and ureters, can have improved anatomical alignment. This can facilitate the flow of contrast medium from the renal pelvis through the ureters into the bladder, particularly in cases where hydration or the normal flow may be obstructed due to hydronephrosis.

In the prone position, the angle at which the urine flows from the renal pelvis into the ureters may be more favorable, allowing for a more complete filling pattern and better visualization of the urinary tract during the examination. This can potentially enhance diagnostic accuracy by providing clearer images of any obstructions or abnormalities that might be present.

Other positions, such as supine or upright, may not encourage the same gravitational flow dynamics necessary for optimal filling of the ureters in cases of hydronephrosis. The left lateral position might provide some benefits for imaging specific structures, but it doesn't offer the same advantages for promoting contrast flow in the setting of hydronephrosis as the prone position does.

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