Ultrasonography and abdominal radiography versus intravenous urography in investigation of urinary tract infection in men: prospective incident cohort study

OBJECTIVES

To compare ultrasonography and abdominal radiography with intravenous urography in the investigation of urinary tract infection in men.

DESIGN

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

SETTING

District general hospital.

PARTICIPANTS

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

INTERVENTIONS

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

MAIN OUTCOME MEASURES

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.

Thyroid screening in congenital hypothyroidism: a review of 41 cases

Forty-one infants have been referred for thyroid scintigraphy following routine screening for congenital hypothyroidism: 14 (35%) were athyreotic, 19 (45%) had an ectopic thyroid, four (10%) were normal and four (10%) demonstrated other abnormalities. There was a female: male ratio of 4:1. Thyroid scintigraphy is a useful adjunct to biochemical screening.

Massive pneumoperitoneum following laser therapy of inoperable oesophageal carcinoma

Two cases of large pneumoperitoneum are described following palliative laser therapy for inoperable oesophageal carcinoma. In both cases there was no constitutional upset and no perforation demonstrated on contrast examination of the oesophagus. The pneumoperitoneum is considered to be due to high pressure CO2, used to keep the tip of the laser clean, passing through the tumour and tracking into the peritoneum. The condition requires only conservative treatment.

Bladder neurofibromas causing ureteric obstruction in Von Recklinghausen's disease

A case of bladder involvement by Von Recklinghausen's disease with consequent hydronephrosis and hydroureters is presented. The intravenous urographic and ultrasonic appearances are correlated.

Bladder neurofibromas causing ureteric obstruction in Von Recklinghausen's disease

A case of bladder involvement by Von Recklinghausen's disease with consequent hydronephrosis and hydroureters is presented. The intravenous urographic and ultrasonic appearances are correlated.