oa Central African Journal of Medicine - Re-evaluation of pre-prostatectomy excretory urography at the University of Calabar Teaching Hospital, (UCTH), Calabar, Nigeria

Volume 34, Issue 5
  • ISSN : 0008-9176



Excretory urograms of 249 patients with a mean age of 63 years presenting between 1982 and 1985 with diagnosis of benign prostatic enlargement, have been reviewed. One hundred and seventy-five of these (70%) were normal, whilst 74 (30%) showed abnormalities which included ureterovesical obstruction (9,6%), urinary calculi (5,6%), hydronephrosis (4,8%) and tumours (2,4%). Using these urograms 186 patients (75%) were assessed for residual urine in their bladders as evidence of urinary outflow obstruction. This was demonstrable in 156 patients (84%), most of which were qualitatively of moderate-to-severe degree. Of all patients only 36 (14%) showed any evidence of hydronephrosis or ureteric stasis, and in only 3 (1,2%) was there evidence of diverticulum of the urinary bladder. Of the 240 patients in whom serum creatinine levels were determined, 33 (14%) showed elevated values, indicating some degree of renal impairment. Our results showed that the most important use of the excretory urography in patients with benign prostatic hypertrophy was in the demonstration of post-micturition residual urine in the bladder as evidence of outflow obstruction. Although a comparatively large number of the urograms showed elevation of the bladder neck by the enlarged prostate, such results could have been obtained by other less expensive clinical methods without recourse to urography. Furthermore, the paucity of associated lesions and abnormalities in this series gives further credence to the view that pre-prostatectomy excretory urography should not be performed as a routine in patients with benign prostatic hypertrophy.

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