The health and cost implications of routine excretory urography before transurethral prostatectomy.

After critically reviewing 601 patients who had undergone transurethral resection of the prostate we conclude that the routine use of excretory urography is not indicated. In the vast majority of patients with only obstructive symptoms or acute urinary retention excretory urography is an expensive test, with an extremely low incidence of useful information. However, its selective use is indicated in cases in which hematuria or a history of renal disease coexists with obstructive symptoms. The time has arrived for physicians to re-evaluate the practices of the past. We all need to participate actively and to make specific recommendations, not generalities. We believe that if the guide lines suggested herein are considered the annual health costs would be decreased by an estimated $75,000,000 and the quality of urologic care would not be jeopardized.