[Radiological investigations to establish etiology in patients with hematuria. A report on nearly 2,000 consecutive cases (author's transl)].

A prospective study was conducted in 1,878 patients found to have hematuria, among 11,000 new cases attending for consultation over a period of 27 months, who were then followed-up for several months to several years. The results confirmed some well-established facts but several unusual features were observed. Intravenous urography, when technically complete, detected urinary tract lesions in 60 p. cent of cases. Complementary examinations (cystoscopy, angiography, renal biopsy), which should not all be conducted systematically, but only as a function of the results of the IVU, the type of hematuria, and clinical and biological findings, considerably increase the percentage of positive results. The etiology remained obscure in less than 10 p. cent of cases but not all of these patients had benefited from a full range of complementary examinations, that should have been conducted. Associated anticoagulant treatment and the microscopic nature of the hematuria should never lead to delay in IVU examination, and a reassuring diagnosis of a benign lesion. The authors emphasize the high frequency of associated lesions. For this reason, a complete IVU should be conducted whatever the initial findings. Furthermore, the reassuring diagnosis of an atypical benign cause for the hematuria (renal cyst, prostatic adenoma, etc.) should not be too easily accepted before exploring the possibility of a second lesion, truly responsible for the hematuria and having an entirely different prognosis.