Ultrasound versus Intravenous Urography in the Evaluation of Patients with Hematuria

Abstract

Objective: The aim was to compare transabdominal ultrasound examination and intravenous pyelography in the
evaluation of patients with hematuria.
Methodology: A prospective study of sixty five patients with micro or macroscopical hematuria who were non
randomly selected at the urosurgical outpatient c-1inic at Azadi General Teaching Hospital a)uhok) during
period from January 2006. tQ November 2007. They wel.e assessed by ultrasound qu/S) & urography (rvu),
i, _^^J-I I-. _L|__ __ _,_ if needed by other sophisticated and invasive nieasures or interv`ention to determine the definite cause of
_ \_ _, --__-70`_r`.I \,` +,I,`-.`.
hematuria. The result of u/S & IVU was compared according to the definite diagnosis.
Results: Out of 43 patients with microscopical hematuria, 23 patients had an obvious cause for hematuria, and
out of22 patients with gross hematuria, 16 patients had a definite disorder, and no cause could be detected in the
rest 26 cases.
Urinary calculi were found in 22 patients, 17 of them detected by U/S and 14 patients were detected by IVU. All
benign (Benign prostatic hypertrophy BPH) or malignant urological tumors (renal and bladder) were diagnosed
by U/S but only 4 of them were detected by IVU. Similarly U/S was diagnostic in all urological infections (5
patients), while none of them `i/as helpful in diagnosing causes in the urethra like stricture or causes without
anatomical changes.
Conclusions: Sixty five patients with micro or macroscopical hematuria were assessed by ultrasound (U/S) &
urography (IVU), to determine the definite cause of hematui.ia. Out of 43 patients with microscopical hematuria,
23 patients had an obvious cause for hemafuria, and out of 22 patients with gross hematuria, 16 patients had a
definite disorder, and no cause could be detected in the rest 26 cases.
Recommendations: Our results are in favor of using U/S in the initial evaluation of hematuria. However we
mustchooseourdiagnostictoolaccordingtothepatient'sconditionandsuspecteddisordercausinghematuria.