Recurrent upper tract urothelial tumours: the use of loopography following cystectomy for bladder cancer.
Recurrent upper tract tumours following cystectomy for transitional cell carcinoma are not uncommon. Conventional follow-up to identify preclinical recurrent disease often involves a combination of excretory urography and urine cytology. This study investigates the possible advantages of loopography in the follow-up of these patients. 41 patients who had undergone cystectomy and ileal loop diversion for transitional cell carcinoma of the bladder were studied. At the time of evaluation with a loopogram, eight out of 41 (19.5%) were symptomatic. Loopography was well tolerated by all of the patients with no reported side-effects or complications from the procedure. Six out of 41 (14.6%) of the loopograms demonstrated an abnormality with recurrent transitional cell carcinoma identified in two patients. In only one case was excretory urography necessary where a ureteric stricture prevented retrograde imaging of the upper tract. Loopography is a safe and well-tolerated investigation for the follow-up of these patients. Excretory urography should be reserved for cases where upper tract imaging is impaired because of obstruction within the loop or ureters.
Noble
J
J
Department of Urology, Middlesex Hospital, London, UK.
Amin
Z
Z
Kessel
D
D
Rickards
D
D
D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion