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Incidental urological findings in patients undergoing computed tomography colonography for investigation of suspected colorectal cancer

Objective: To determine the rate of incidental urological findings in patients undergoing computed tomography (CT) colonography/CT colonoscopy (CTC) for investigation of suspected colorectal cancer. Methods: Retrospective analysis of patients undergoing CTC between January 2011 and December 2013. All patients with new incidental urological findings were included with their type and number of urological findings. These were stratified as per the colonography reporting and data system (C-RADS) criteria, and a note made of any further imaging, intervention and histology where appropriate. Results: Within the time period, n = 1891 CTCs were undertaken. Of these, n = 333 (17.6%) had an incidental urological finding and n = 41 of these patients had dual incidental urological pathologies. In total, n = 49 had significant pathology which required monitoring, further imaging, and medical or surgical intervention; n = 12 required further imaging. In n = 1, the imaging result led to a decision to operate and in n = 9 the results excluded the need for surgical intervention; n = 24 underwent operative intervention. The rates of incidental urological findings were similar to those quoted in literature. Conclusion: Our study demonstrates a 17.6% rate of incidental urological findings. Of all findings, 13.1% were deemed significant to warrant further investigation or intervention, and 7.2% of patients with urological findings required intervention. CTCs can adequately image renal masses and further imaging of renal masses did not change management. Level of evidence: 4