Reevaluation of usefulness of excretory urography in the diagnosis of urological diseases

Excretory urography (IVP) has been used as a screening test for urological diseases for the past several decades. The useflness of IVP, however, might be lessened or at least changed, since the recent development of technology has produced new diagnostic devices such as ultrasonography (US) and computed tomography (CT). Therefore, IVP was compared with US and CT in regard to their diagnostic value in urological disorders. The subjects chosen for this investigation were 397 inpatients who underwent IVP in the Department of Urology of Osaka Medical School Hospital between 1982 and 1986, and 35 outpatients referred to the Department of Urology of Saiseikai Ibaraki Hospital from other clinics in 1986 and 1987, because US had shown abnormal findings suspicious of a urological problem. Although IVP was less useful than US or CT in the basic diagnosis of retroperitoneal or renal mass or injury of the kidney, it was more useful in the diagnosis of urinary calculi and diseases of the ureter. Excretory urography also provides valuable information in the follow-up of patients after surgical treatment for urological diseases. In conclusion, IVP still remains one of the most useful examinations in current clinical urology despite the fact that new diagnostic devices, including US and CT, are now widely employed. (author)