Intravenous urography in evaluation of acute retention

The intravenous urograms of 894 patients with acute retention were assessed. The total number of lesions demonstrated was less than 1 per cent; consequently the value of routine intravenous urograms in patients with acute urinary retention is questioned.     

Intravenous urography after acute urinary retention.

The results of a 12-month prospective study of 113 patients show that intravenous urography has no place in the management of men with acute urinary retention without haematuria.     

Intravenous urography in evaluation of asymptomatic microscopic hematuria

BACKGROUND AND PURPOSE: In 2001, the American Urologic Association Best Practice Policy Panel recommended CT or intravenous urography (IVU) over ultrasonography as the initial imaging modality in patients with asymptomatic microhematuria. We here present results of a study initiated many years ago and completed prior to 2001 that provides information pertinent to the use of IVU as the initial imaging modality for such patients. PATIENTS AND METHODS: This study compared the results of IVU and ultrasonography in patients 40+ years of age who were referred to a single urology department for evaluation of microscopic hematuria between 1994 and 2000. There were 290 patients who agreed to participate by undergoing ultrasonography in addition to IVU; 247 completed both tests. There were 81 men and 166 women with a mean age of 56.4 years (range 40-86 years). Thirty patients (12%) were smokers. RESULTS: A renal lesion or mass suggestive of tumor was found in 8 patients (3.2%); 3 patients had this finding on the IVU examination and 5 on ultrasonography. None of the patients had such a lesion/mass on both examinations. Two patients with suspect lesions were ultimately found to have renal-cell carcinoma. Both of the patients with renal cancer had a suspect lesion on the ultrasound examination but not on the contemporaneous IVU. CONCLUSION: Intravenous urography may miss lesions/masses that lead to a diagnosis of upper-tract neoplasia.     

Intravenous excretory urography using Optiray in office urology

Experiences with the nonionic contrast medium Optiray^® 300 were analyzed in 120 consecutive patients who underwent intravenous urography. Allergic diathesis was recorded prior to the examination in 12.5% of the patients, pretreatment was given in only 3 cases. The clinical safety of Optiray was outstanding, no adverse reactions were noted. Diagnostic quality of the radiographs was excellent in 78% and good in 22% of the cases. Optiray is considered to be a safe and effective contrast agent for use in intravenous excretory urography.     

Intravenous urography as a routine examination in epididymitis-a re-evaluation

One hundred and twenty-seven intravenous urograms of patients with acute epididymitis were evaluated during a period of 9 years. The majority of these patients had normal urograms. A tuberculous renal lesion was found in only one case. Twenty-seven patients had prostatic enlargement and 10 of these were under 50 years of age. Other abnormalities which were found were not related to epididymitis. It is suggested that intravenous urography is indicated in patients with acute epididymitis only when there is evidence of previous tuberculosis or when laboratory findings arouse suspicion of genitourinary tuberculosis.     

Intravenous urography: important adjunct for diagnosis of bladder tumours

The intravenous urogram (IVU) has long been considered important for the evaluation of haematuria. A retrospective review of 64 patients with haematuria and subsequent histologically proven carcinoma of the bladder revealed that bladder tumours could be diagnosed pre-operatively in 34 of 46 (76%) of patients with gross haematuria and 12 of of 18 (67%) of those with microhaematuria. Fifteen of 20 IVUs available for review disclosed filling defects on the post-void view in 15/15 (100%), the anteroposterior view in 13/15 (87%), and the oblique view in 7/14 (50%). The IVU, especially the post-void view, permits pre-operative detection of bladder tumours in a majority of patients and can alert the clinician to the need for urgent cystoscopy.     

静脉尿路造影辅助CT仿真内窥镜诊断膀胱肿瘤

目的　探讨IVU造影辅助CT仿真内窥镜 (CTVC)诊断膀胱肿瘤的临床价值。　方法　经IVU、CT仿真内窥镜检查 2 2例膀胱肿瘤病人 ,获得的图像信息与膀胱镜所见及手术结果比较分析。　结果　 2 2例病人经CTVC发现浅表乳头状瘤 18个 ,结节、团块乳头状瘤 11个 ,浸润性肿瘤1个。肿瘤直径最小 3.0mm。与膀胱镜检查及手术结果完全符合。根据CTVC图像结合断层CT扫描分析参照膀胱镜分型将膀胱肿瘤分为 3型 :(1)浅表乳头状瘤 ,(2 )结节、团块状乳头状瘤 ,(3)浸润性肿瘤。　结论　CTVC是一种新的无创检查方法 ,可以显示直径 >3.0mm突入膀胱的肿瘤和肿瘤表面特征、肿瘤与输尿管口及膀胱颈的关系、膀胱粘膜情况 ,对膀胱肿瘤诊断有较高的实用价值     

Intravenous urography with a nonionic low osmolality contrast medium (iopamidol) in elderly patients

Intravenous urography was carried out with a nonionic low osmolality contrast medium, iopamidol (Iopamiron 300) in 30 elderly patients (aged 65 to 86; with the mean age of 75 +/- 6), and the safety for the aged and radiopacity were evaluated. Although no purgative was given and water was not restricted in consideration of dehydration and bad influence on renal function, the total urinary system was well visualized. Side-effect was observed in none of 30 patients. This method seems to be useful for patients with a risk of dehydration and elderly patients.     

Optimizing urography

Urography is regarded as one of the best screening tests for evaluation of urinary tract disease and is commonly used in the search for a cause of hematuria or the presence of upper tract urothelial masses. It is also used in the evaluation of patients with trauma, known or suspected urolithiasis, or renal infection and for the documentation of obstruction or congenital abnormalities. The physician should have a basic understanding of iodinated contrast media and their benefits and effects on the patient. Patient risk factors include a history of (1) renal impairment, (2) significant allergies, (3) asthma, (4) diabetes mellitus, and (5) cardiac disease (particularly congestive heart failure, arrhythmias, unstable angina, recent myocardial infarction, and primary pulmonary hypertension). Changing options for imaging modalities, contrast media, and patient preparation require continued attention to detail and individualization to allow optimization of the urographic examination.