Corrie D, Thompson I M
J Urol. 1987 Sep;138(3):554-6. doi: 10.1016/s0022-5347(17)43255-1.
A 5-year retrospective study of 131 hematuria patients (23 with gross and 108 with microscopic hematuria) undergoing retrograde pyelography solely for fractional visualization of the upper tracts on excretory urography revealed no tumors or other significant pathological condition in the 187 renal units (56 bilateral cases) studied. A review of our cases of upper tract urothelial cancer since 1955 revealed 36 patients with complete records of the urological evaluations. None of the cases was diagnosed by retrograde pyelography for fractionally visualized excretory urography and 3 were within 9 months of a previously normal excretory urogram alone or with retrograde pyelography. We believe that retrograde pyelography done solely to evaluate a fractionally visualized upper tract may miss subtle lesions and it should not terminate the evaluation. We recommend that excretory urography, cystoscopy and voided urine cytology studies be performed initially and, if normal, they should be repeated in 6 and 12 months before upper tract urothelial tumors are ruled out.
一项针对131例血尿患者（23例肉眼血尿和108例镜下血尿）的5年回顾性研究，这些患者仅因排泄性尿路造影时上尿路分段显影而行逆行肾盂造影，结果显示在研究的187个肾单位（56例双侧病例）中未发现肿瘤或其他显著病理状况。回顾我们自1955年以来的上尿路尿路上皮癌病例，发现36例患者有完整的泌尿外科评估记录。这些病例中无一例通过逆行肾盂造影诊断为排泄性尿路造影分段显影异常，且有3例仅在之前正常的排泄性尿路造影单独检查或联合逆行肾盂造影检查后的9个月内发病。我们认为，仅为评估上尿路分段显影而进行的逆行肾盂造影可能会遗漏细微病变，不应以此终止评估。我们建议最初应进行排泄性尿路造影、膀胱镜检查和尿脱落细胞学检查，如果结果正常，在排除上尿路尿路上皮肿瘤之前，应在6个月和12个月时重复检查。
