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At least 937 records · Page 52Linked to original sources
PubMed1996

Is intravenous urography indicated in a young adult with hematuria?

OBJECTIVES: Published reports are devoid of U.S. studies investigating the role of the intravenous urogram (IVU) in adult patients of differing ages with hematuria. To evaluate the efficacy of the IVU in patients less than 55 years old, a retrospective analysis was performed. METHODS: The records of all patients (n = 800) undergoing IVU in an inner city hospital from January 1991 through October 1994 were reviewed for age, gender, race, urinalysis data, and cystoscopic and biopsy findings. Age greater than 55 years, recent trauma, and known malignancy were exclusion criteria. Hematuria was the indication for IVU in 128 of 800 patients. Eight (6.2%) of 128 patients had inadequate chart information, leaving a total of 120 evaluable charts. RESULTS: We stratified the 120 patients by age, degree of hematuria (gross versus microscopic), and gender. The younger group (17 to 40 years old) included 64 patients (53%) and the older group (41 to 55 years old) 56 patients (47%). Gross hematuria was reported in 65 patients (54%), whereas 55 (46%) had microscopic hematuria. Men accounted for 78 patients (65%) and women for 42 (35%). The majority of patients were African-Americans (100 [83%] of 120). Abnormal findings were seen in 17 (14%) of 120 patients. The IVU alone provided no diagnosis of immediate consequence. There was no significant difference in findings between the age groups (P = 0.61), gross and microscopic hematuria (P = 0.28), and men and women (P = 0.59). Contrast reactions occurred in 3 (2.5%) of 120 patients. CONCLUSIONS: In this inner city population younger than 55 years of age, the usefulness of the IVU for the evaluation of hematuria is questionable. It did not establish a diagnosis, modify the subsequent evaluation, or change the therapy in any of our patients.

Adult↗
PubMed1977

Intravenous urography in the management of acute retention.

A retrospective analysis of the frequency of requests for an intravenous urogram (I.V.P.) in men with acute retention of urine showed that this investigation was performed in 82%. In no instance, however, did the urographic findings influence the decision to operate or the type of operation performed. The introduction of a specialised urological service did not reduce the number of I.V.P.s requested because most referrals to the urologist were made after the I.V.P. Patients who had an I.V.P. waited on average 8 days from admission to operation compared with 3-5 days for those who did not. We conclude that no purpose is served by a routine I.V.P. in every male patient admitted to hospital with acute retention of urine.

Acute Disease↗
PubMed2003

Correlation between filling defect patterns on urography and pathologic staging of ureteral transitional cell carcinomas.

Although a filling defect within the ureter is the most common finding with ureteral transitional cell carcinomas (TCCs), little is known about the correlation between filling defect patterns and pathologic findings. This study was conducted to address this. Between January 1995 and January 2003, 126 pathologically confirmed TCCs of the ureter were included in our study. We classified urographic filling defects into four patterns: ovoid, polypoid, infiltrating, and plaque-like. The correlation between different filling defect patterns and pathologic findings was assessed using Pearson's Chi-squared and logistic regression methods. There were 28 (22%) ovoid filling defects, 42 (33%) polypoid filling defects, 37 (29%) infiltrating filling defects, and 19 (15%) plaque-like filling defects. Infiltrating and plaque-like filling defects were significantly associated with more advanced disease compared to ovoid and polypoid filling defects (odds ratio, 6.75; 95% confidence interval, 3.04-14.98; p < 0.0001). Our results suggest that filling defect presentations may signify different invasive behavior among TCCs. The distribution of ovoid, polypoid, infiltrating, and plaque-like filling defect patterns is significantly different between superficial and advanced ureteral TCCs. We suggest that classifying the filling defect patterns of ureteral TCCs may provide important preoperative information for planning treatment and predicting outcome.

Adult↗