Usefulness of computed tomography performed immediately after excretory urography in patients with delayed opacification or dilated upper urinary tract of unknown cause

Sebastiá, Carmen; Quiroga, Sergi; Buñesch, Laura; Boyé, Rosa; Salvador, Rafael; Nicolau, Carlos

doi:10.1007/s00261-011-9771-4

Cited by 4 publications

(2 citation statements)

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“…In a direct comparison of CT urography and excretory urography in a cohort of more than 100 patients, a significantly greater accuracy of CT urography was reported (sensitivity 93%, specificity 94%) [24] . Even if a CT is performed immediately after a conventional IVU with delayed excretion, a correct diagnosis has been reported in 97% of cases [25] .…”

Section: Discussionmentioning

confidence: 99%

Upper Urinary Tract Tumors: Which Diagnostic Methods Are Needed?

Maruschke

Kram²,

Zimpfer³

et al. 2017

Urol Int

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Objectives: We reviewed the data of patients with upper urinary tract (UUT) tumors to evaluate the effectiveness of diagnostic procedures. Methods: This retrospective study evaluated tumor characteristics, imaging procedures, epidemiological and follow-up data of 113 patients. We analyzed the importance of non-invasive and endoscopic diagnosis in addition to imaging as well as the influence of stage and grade on recurrence rate. Results: Most tumors were urothelial carcinomas (92.9%). The cardinal symptoms were hematuria (40.7%), flank pain (2.7%), and urinary obstruction (14.2%). Forty-seven patients received intravenous urograms (IVUs), 57 retrograde ureteropyelography (RUP), 89 CTs, 6 an MRI. The correct positive tumor identification was reached by IVU in 27/47 patients, by RUP in 50/57, by CT in 74/89, and by MRI in 3/6 patients representing sensitivities of 57.4% (IVU), 87.7% (RUP), 83.1% (CT), and 50% (MRI). Sixty-four patients had urine cytology, which was correctly positive in 60.9% and 56 had a diagnostic ureterorenoscopy, which was correctly positive in 83.9%. During follow-up more than 20% of patients developed a recurrence. Conclusion: In patients with hematuria and flank pain, UUT must be considered a differential diagnosis. UUT to the extent of 76.6% showed more invasive growth (>Ta). Thus, rapid and efficient diagnosis based primarily on imaging is required. Contrast CT scan seems to be the imaging modality with the best performance. However, often only a combination of diagnostic procedures gives a certain diagnosis. Due to the high recurrence rate, close follow-up is needed.

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Section: Discussionmentioning

confidence: 99%

Upper Urinary Tract Tumors: Which Diagnostic Methods Are Needed?

Maruschke

Kram²,

Zimpfer³

et al. 2017

Urol Int

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“…This method shows superior [43] specificity and sensitivity compared with Intra Venous Pyelography urography. Combined IVU and CT study allowed correct diagnosis of the underlying cause of delayed excretion or upper urinary tract dilatation in 97% of cases, reducing time and radiation [44]. …”

Section: Reviewmentioning

confidence: 99%

Recent finding and new technologies in nephrolithiasis: a review of the recent literature

et al. 2013

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This review summarizes recent literature on advances regarding renal and ureteral calculi, with particular focus in areas of recent advances in the overall field of urolithiasis. Clinical management in everyday practice requires a complete understanding of the issues regarding metabolic evaluation and subgrouping of stone-forming patients, diagnostic procedures, effective treatment regime in acute stone colic, medical expulsive therapy, and active stone removal. In this review we focus on new perspectives in managing nephrolitihiasis and discuss recentadvances, including medical expulsive therapy, new technologies, and refinements of classical therapy such as shock wave lithotripsy, give a fundamental modification of nephrolithiasis management. Overall, this field appears to be the most promising, capable of new developments in ureterorenoscopy and percutaneous approaches. Further improvements are expected from robotic-assisted procedures, such as flexible robotics in ureterorenoscopy.

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