Hawthorne and his colleagues correctly point out, and we agree, that ureteral catheterization as initially described by Stamey et al1 is the most accurate method to localize the site of infection within the urinary tract. As they have noted in their investigation, there may be difficulties in interpretation of the study because some patients had to be excluded from the final analysis.2
In our early investigations we found that the BW test findings correlated adequately with those of the ureteral catheterization study; therefore, we did not enlarge our data base and publish our findings. The BW test is also less invasive, less costly, and well accepted by patients. However, the BW test cannot be used to identify which kidney is involved if there is unilateral upper urinary tract infection.
We, as well as other investigators, think that the BW test, originally described by Fairley et al