Role of renal sonography and its use as an alternative to intravenous urography in detecting ureteral obstruction or hydronephrosis in patients with cervical cancer.

Abstract

Purpose : The aim of this prospective study was to evaluate the role of renal sonography and its use as an alternative or screening to intravenous urography in detecting ureteral obstruction or hydronephrosis in patients with cervical cancer.

Materials and methods : Patients with biopsy-confirmed carcinoma of the cervix who were referred to urologist for cystoscopy and proctoscopy from January 2011, through December 2011, were enrolled in this trial. All patients had previously undergone clinical staging by physical examination and either intravenous urography as the standard tests for diagnosing ureteral obstruction or hydronephrosis. All patients underwent renal sonography as an alternative diagnostic tool for diagnosing ureteral obstruction or hydronephrosis.

Results : Forty-two patients were enrolled. Their mean age was 51.9 years (range,34-80 years). Histologic subtypes of invasive cervical carcinoma include squamous cell carcinoma 30 patients, adrenocarcinoma 11 patients and lymphoma 1 patient. According to the FIGO staging system, 1 patient had clinical stages 1a disease, 7 patients had stage 1b, 2 patients had stage 2a, 15 patients had stage 2b, 14 patients had stage 3b and 3 patients had stage 4a. Thirty-six patients had had intravenous urography. Sensitivity,specificity, positive and negative predictive values and overall accuracy rates for renal sonography were 100 percent (7/7), 98.5 percent (64/65), 87.5 percent (7/8), 100 percent (64/64), and 98.6 percent (71/72), respectively.

Conclusions : Renal sonography may be used as an effective and relatively low-cost means of diagnosing ureteral obstruction in patients with cervical cancer. It can be used alternative investigation. Intravenous urography is not needed when cystoscopy, proctosigmoidoscopy