Ultrasonography and abdominal radiography versus intravenous urography in investigation of urinary tract infection in men: prospective incident cohort study.
OBJECTIVE
To compare ultrasonography and abdominal radiography with intravenous urography in the investigation of urinary tract infection in men.


METHODS
Prospective study in two hospital departments. Radiological procedures and urological assessments performed on different days by different clinicians


METHODS
District general hospital.


METHODS
Consecutive series of men (n=114) referred to the department of urology for investigation of proved urinary tract infection.


METHODS
Ultrasonography and intravenous urography of renal tract and assessment of urinary flow rate. Clinical assessment, cystoscopy, urodynamic studies, and transrectal ultrasonography with biopsy.


METHODS
Sensitivity and specificity of ultrasonography and abdominal radiography compared with intravenous urography.


RESULTS
Important abnormalities were seen in 53 of 100 fully evaluated patients, the most common being a poorly emptying bladder (34). The combination of plain radiographs of kidneys, ureter, and bladder and ultrasonography detected more abnormalities than intravenous urography alone. No important abnormality was missed by this combination (sensitivity 100% and specificity 93%).


CONCLUSIONS
Ultrasonography with abdominal radiography is as accurate as intravenous urography in detecting important urological abnormalities in men presenting with urinary tract infection. This combination is safer than intravenous urography and should be the initial investigation for such patients. Additional determination of urinary flow rate is useful for the assessment of an incompletely emptying bladder.
Andrews
S J
SJ
Department of Urology, Lister Hospital, Stevenage, Hertfordshire SG1 4AB.
Brooks
P T
PT
Hanbury
D C
DC
King
C M
CM
Prendergast
C M
CM
Boustead
G B
GB
McNicholas
T A
TA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011860:Radiography, Abdominal; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D001745:Urinary Bladder Diseases / Q000150:complications / Q000175:diagnosis; D014545:Urinary Calculi / Q000150:complications / Q000175:diagnosis; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging* / Q000209:etiology; D014563:Urodynamics; D014567:Urography / Q000379:methods