Is routine excretory urography necessary at first diagnosis of bladder cancer

ABSTRACTPurpose: We determined whether routine excretory urography (IVP) at initial diagnosis of bladder cancer is useful in screening the upper urinary tract for clinically inapparent urothelial tumors.Materials and Methods: IVPs and ultrasound findings of 314 patients with bladder cancer were reviewed retrospectively.Results: Only 1 silent upper urinary tract tumor was detected with IVP (0.3%), resulting in nephroureterectomy. IVP had no further therapeutic consequences except for destruction of an asymptomatic prevesical stone. IVP was followed by ureterorenoscopy in 5 patients with negative results. Upper urinary tract obstruction could be documented equally well by sonography in all cases.Conclusions: Routine IVP at first diagnosis of bladder cancer is unnecessary.