Intravenous urography in patients with transitional cell carcinoma of the bladder. The incidence and implications of ureteral obstruction.
In order to study the value of excretory urography in the diagnosis of transitional cell carcinoma of the bladder, and also the incidence and implications of ureteral obstruction, 100 consecutive patients were studied. Of 73 patients with superficial tumours (stages Tis, Ta, T1) only 1 (1,4%) had hydronephrosis as a result of the bladder tumour. However, 2 further patients had hydronephrosis secondary to synchronous ureteral tumours. Of the 27 patients with muscle-invasive tumours, 10 (37%) had hydronephrosis at the time of diagnosis. Four patients who had normal upper tracts initially, developed hydronephrosis during follow-up: 1 due to progression of a superficial tumour to stage T3, 1 due to the development of an ureteral tumour, and 2 due to fibrosis of the intramural ureter after transurethral resection of superficial tumours. The presence of ureteral obstruction at the time of diagnosis most often implies a muscle-invasive tumour, but the possibility of a synchronous ureteral tumour must also be considered. Fibrous strictures of the distal ureter can occur after transurethral resection of superficial bladder tumours.
Allen
F J
FJ
Department of Urology, University of Stellenbosch, Parowvallei, CP.
Steenkamp
J W
JW
D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D014567:Urography