The effect of intravenous pyelography and cystoscopy on the staging of cervical cancer.

Intravenous pyelography and cystoscopy were performed in 583 patients with invasive cervical cancer at the University of Kentucky Medical Center. Eighty-six patients were found to have ureteral obstruction, which occurred most commonly at or near the ureterovesical junction. The incidence of ureteral obstruction varied from 2.2% in patients with pelvic findings consistent with Stage I disease to 36% in patients with Stage IV disease. No patient with Stage I or II disease on pelvic examination was found to have invasive cervical cancer in the bladder. However, bladder invasion occurred in 27 patients initially thought to have Stage IIIB disease.Intravenous pyelography should be performed as part of staging in all patients with cervical cancer, whereas cystoscopy can be reserved for those initially thought to have Stage III or IV disease.