Is Routine Excretory Urography Necessary at First Diagnosis of Bladder Cancer?

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Abstract
We determined whether routine excretory urography (IVP) at initial diagnosis of bladder cancer is useful in screening the upper urinary tract for clinically inapparent urothelial tumors. IVPs and ultrasound findings of 314 patients with bladder cancer were reviewed retrospectively. Only 1 silent upper urinary tract tumor was detected with IVP (0.3%), resulting in nephroureterectomy. IVP had no further therapeutic consequences except for destruction of an asymptomatic prevesical stone. IVP was followed by ureterorenoscopy in 5 patients with negative results. Upper urinary tract obstruction could be documented equally well by sonography in all cases. Routine IVP at first diagnosis of bladder cancer is unnecessary.