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Role of intravenous urography and transabdominal ultrasonography in the diagnosis of bladder carcinoma.

INTRODUCTION
The present study was carried out to compare the efficacy of transabdominal ultrasonography and intravenous urography in the diagnosis of bladder carcinoma in those patients presenting painless hematuria.


MATERIALS AND METHODS
Medical records of 100 patients who had both ultrasonography and intravenous urography were studied. The reported findings of these investigations were correlated with those of cystoscopy.


RESULTS
Ultrasonography was significantly more sensitive (96%) in the detection of bladder carcinoma compared to urography (87%). By applying the test of equality of proportions, the value of Z is 2.28, which is statistically significant (p < 0.01). In addition, ultrasonography was more sensitive in clarifying the pathology in upper renal tracts i.e. ureteric obstruction secondary to bladder carcinoma when urography failed due to none or poor excretion of contrast.


COMMENTS
We recommend the use of ultrasonography as the initial radiological investigation for detection of bladder carcinomas in patients presenting hematuria. Ultrasonography is safe, easily available, cost effective and provides images of both upper and lower renal tract. Patients diagnosed to be suffering from bladder carcinoma by ultrasonography should be scheduled directly and promptly for cystoscopy and bladder tumor resection.