Holmäng S, Hedelin H, Anderström C, Holmberg E, Johansson S L
Department of Urology and Oncological Centre, Sahlgrenska University Hospital, Göteborg, Sweden.
J Urol. 1998 Jul;160(1):45-8.
We evaluate whether routine excretory urography is needed in the long-term followup of patients with bladder carcinoma.
A total of 680 patients with an initial diagnosis of bladder carcinoma from 1987 to 1988 in western Sweden were prospectively registered and followed for at least 5 years. All carcinomas of the kidney, renal pelvis and ureter, and all surgically treated cases of ureteral stricture were registered.
During followup renal pelvic or ureteral carcinoma developed in 16 patients, renal cell carcinoma was diagnosed in 2 and 6 underwent surgery for benign obstruction of the distal ureter.
The low annual incidence of malignant upper urinary tract and renal tumors as well as ureteral strictures supports our opinion that routine imaging of the upper urinary tract is not indicated during followup of patients with bladder carcinoma. We recommend urography at initial diagnosis of bladder carcinoma, when tumor progression occurs and when symptoms or signs raise suspicion of upper urinary tract disease.
我们评估在膀胱癌患者的长期随访中是否需要进行常规排泄性尿路造影。
对1987年至1988年在瑞典西部初次诊断为膀胱癌的680例患者进行前瞻性登记，并随访至少5年。记录所有肾盂、输尿管癌以及所有接受手术治疗的输尿管狭窄病例。
随访期间，16例患者发生肾盂或输尿管癌，2例诊断为肾细胞癌，6例因输尿管远端良性梗阻接受手术。
上尿路恶性肿瘤和肾肿瘤以及输尿管狭窄的年发病率较低，这支持了我们的观点，即在膀胱癌患者的随访期间无需对上尿路进行常规影像学检查。我们建议在膀胱癌初诊时、肿瘤进展时以及出现症状或体征怀疑上尿路疾病时进行尿路造影。
