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To assess the role of routine intravenous pyelography (IVP), rectoscopy and additional imaging techniques like computed tomography (CT) and abdominal ultrasonography (USG) for the evaluation of patients with endometrial cancer. A total of 97 women with endometrial cancer (82 endometrioid and 15 non-endometrioid type) of all stages (Stage I = 65, II = 14, III = 13, IV = 5) were included in the study. Of these, 50 women were admitted because of postmenopausal bleeding, 24 with irregular vaginal bleeding and 7 with pain and leucorrhea, whereas the others had no complaints. Only one patient had symptoms related to the gastrointestinal system, but none for the urinary system. Preoperative CT ( n = 45), IVP ( n = 78), rectoscopy ( n = 46), and USG or colonoscopy ( n = 37) were performed on our patients. All the women had total abdominal hysterectomy and bilateral salpingo-oophorectomy, with/without pelvic ( n = 81) and paraaortic ( n = 34) lymphonodectomy, and omentectomy ( n = 35). In 39 of 45 women who had CT, it had no effect on the operation and did not facilitate the operation. In two women there were pathological findings on CT and some interventions (resection and anastomosis) were performed on the gastrointestinal tract in these patients. However, CT had overcome pathological findings related with the gastrointestinal or urinary systems in four women, who needed interventions to these systems during the operation. CT was not performed on six women who needed interventions to the gastrointestinal system during the operations. Three patients had pathological findings (fissure, external compression) in rectoscopy, but only one patient had ileo-transverstomy, in which rectoscopic finding had not predicted the necessity of that procedure. Out of 78 IVP, the only finding was external compression to the bladder in 38 patients, and this finding had no contribution to the operation. Among women who had USG or colonoscopy ( n = 37) performed, five had pathological findings that contributed to the extensiveness or the mode of the operations (liver nodules, polyps in the colon). Routine preoperative computed tomography, intravenous pyelography, rectoscopy or abdominal USG and colonoscopy have little impact on the decision and the prediction of the extensiveness of the operation. [ABSTRACT FROM AUTHOR]

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The diagnostic value of cystoscopy and intravenous pyelography in the staging of carcinoma of the corpus uteri was evaluated in a retrospective study of 218 patients. The primary treatment in all patients was surgical. Cystoscopy was performed preoperatively in 71 (33%) of the patients and postoperatively in 90 (41%); 57 (26%) patients were not subjected to this investigation. Intravenous pyelography was performed in 95 (44%) of the patients and postoperatively in 70 (32%); 53 (24%) patients were not subjected to this investigation. In no patient did cystoscopy reveal invasion of the bladder by tumor. In one patient with a stromal sarcoma (stage IV), there was no flow of dye through the ureteral orifices. Intravenous pyelography revealed unilateral ureteral obstruction in one case of stromal sarcoma (stage III) and complete bilateral ureteral obstruction in another case (stage IV). These findings show that cystoscopy and intravenous pyelography are unnecessary in carcinoma of the corpus uteri at stages I and II, and that in stages III and IV the necessity for these investigations should be considered for each patient on an individual basis. [ABSTRACT FROM AUTHOR]

Objective: To determine: 1) whether a simple clinical prediction rule could identify emergency department patients with ureteral calculi; 2) whether the kidney, ureter, and bladder (KUB) radiograph provides diagnostic information beyond that obtained from the history and physical examination; and 3) whether ureteral calculi can be diagnosed accurately in the emergency department without emergency excretory urography, commonly known as intravenous pyelography (IVP).Patients: Two hundred three patients who underwent emergency KUB and IVP studies for nontraumatic abdominal or flank pain (derivation group) were retrospectively identified from radiology department records; 72 patients were prospectively evaluated in the emergency department for suspected ureteral stones (validation group).Measurements: Clinical information included age, gender, characteristics of pain, associated symptoms, presence of fever, history of ureteral calculi, whether a stone was passed, and results of urinalysis and KUB and IVP studies. All KUB and IVP radiographs were independently reviewed by a radiologist blinded to the patient's clinical information and urinalysis results.Design: Stepwise linear discriminant analysis was used to derive a four-item prediction rule from the derivation group and the validation group; the areas under the receiver operating characteristic (ROC) curves and the misclassification rates were compared.Results: The four-item rule (acute onset, flank pain, hematuria, and positive KUB radiograph) correctly classified 83% of patients in the derivation group and 90% in the validation group. The four-item rule had an ROC area of 0.86 in the derivation group and 0.89 in the validation group. The KUB radiograph significantly improved the discriminant ability of the two history items and the urinalysis result. Thirty-three percent of patients were identified to be in a subset with a 96% probability of having a stone.Conclusion: These findings, which should be confirmed in another emergency department, suggest that subsets of patients with suspected ureteral calculi may be managed without emergency IVP; this approach thereby reduces the time a patient spends in the emergency department, radiation exposure, expense, and morbidity. [ABSTRACT FROM AUTHOR]

A group of women with carcinoma of the cervix was studied by renography and i.v. pyelography. The incidence of renal and urinary tract disorders detected by these tests increased as did the stage of the disease, being 17.1% with Stage I carcinoma of the cervix, 27.8% with Stage II carcinoma of the cervix, 47% with Stage III carcinoma of the cervix, and 83.3% in Stage IV carcinoma of the cervix. In patients with Stage I and Stage II carcinoma of the cervix, those selected for radiotherapy had twice the incidence of abnormal renograms as those selected for surgery. This difference probably reflected a higher incidence of medical disorders affecting renal and urinary tract function in those considered unfit for surgery. We believe that renograms should be used routinely as a screening test in patients with carcinoma of the cervix. [ABSTRACT FROM AUTHOR]

Four boys, each with urethral obstruction caused by a prolapsed simple ureterocele (from a non-duplicated collecting system) are reported. This is an unusual complication of an uncommon anomaly. [ABSTRACT FROM AUTHOR]

The urograms of 186 boys and 145 girls were scrutinized in order to reveal the incidence of ureteral jets demonstrable during intravenous pyelography (IVP). In this series a unilateral jet was observed in 26 cases and a bilateral jet in 6 cases. Ureteral jets were almost three times as common in patients with normal urograms compared with those revealing urinary abnormalities. The incidence of a positive jet sign, usually unilateral, varies with the employed technique of examination, but the highest incidence in routine IVP seems to be about 30%. Although infrequent, significant ipsilateral vesicoureteral reflux (VUR) may occur. This fact together with the reported low rate of bilateral jets restricts the value of uneteral jets being used as an indicator of absence of gross VUR. The need for micturition cysto-urethography (MCU) at the uro-radiological work-up remains unchallenged. [ABSTRACT FROM AUTHOR]

A randomized, double-blind clinical trial was performed to compare a higher dose of conventional ionic contrast media (diatrizoate) with a lower dose of a new, nonionic contrast material (ioversol) for excretory urography (EU). One hundred twenty patients were randomized to receive either 100 ml of diatrizoate (Renografin-60) or 75 ml of ioversol (Optiray-320). Despite the lower iodine dose, the use of ioversol resulted in significantly better opacification of the calyces, renal pelves, and ureters. There was no significant difference in renal parenchymal opacification, opacification of the urinary bladder, or distention of the collecting system. We conclude that high-quality EU can be performed with a lower iodine dose using ioversol. [ABSTRACT FROM AUTHOR]

Intravenous pyelography was performed in a woman with severe (grade IV) pelvic organ prolapse. The imaging of the bladder suggested a neoplasm, but at cystoscopy the diagnosis proved to be severe bladder trabeculation. [ABSTRACT FROM AUTHOR]