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Ureteral Dilatation with No Apparent Cause on Intravenous Urography: Normal or Abnormal? A Pilot Study.

Rathi V, Agrawal S, Bhatt S, Sharma N - Adv Urol (2015)

Bottom Line: Extrinsic vascular compression and strictures did not appear to be clinically significant in our study.We conclude that ureteral dilatation with no apparent cause on IVU may indicate urinary tract tuberculosis, urinary tract infection (E. coli), or a missed calculus.Thus, cases with a dilated ureter on IVU, having no obvious cause, should undergo a detailed clinicoradiological evaluation and CTU should be used judiciously.

View Article: PubMed Central - PubMed

Affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India.

ABSTRACT
A pilot study was done in 18 adults to assess the significance of ureteral dilatation having no apparent cause seen on Intravenous Urography (IVU). A clinicoradiological evaluation was undertaken to evaluate the cause of ureteral dilatation, including laboratory investigations and sonography of the genitourinary tract. This was followed, if required, by CT Urography (using a modified technique). In 9 out of 18 cases, the cause of ureteral dilatation on laboratory investigations was urinary tract infection (6) and tuberculosis (3). In the remaining 9 cases, CTU identified the cause as extrinsic compression by a vessel (3), extrinsic vascular compression of the ureter along with ureteritis (2), extrinsic vascular impression on the right ureter and ureteritis in the left ureter (1), ureteral stricture (2), and ureteral calculus (1). Extrinsic vascular compression and strictures did not appear to be clinically significant in our study. Hence, ureteral dilatation without any apparent cause on intravenous urogram was found to be clinically significant in 12 out of 18 (66.6%) cases. We conclude that ureteral dilatation with no apparent cause on IVU may indicate urinary tract tuberculosis, urinary tract infection (E. coli), or a missed calculus. Thus, cases with a dilated ureter on IVU, having no obvious cause, should undergo a detailed clinicoradiological evaluation and CTU should be used judiciously.

No MeSH data available.


Related in: MedlinePlus

(a) Scout film shows a left renal calculus. An oval calcified node (arrow) lies outside the line of the ureter in (b). (b) Intravenous urogram shows dilated ureters with no apparent cause. Acid-fast bacilli on microscopic examination and culture of urine confirmed tuberculosis.
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fig1: (a) Scout film shows a left renal calculus. An oval calcified node (arrow) lies outside the line of the ureter in (b). (b) Intravenous urogram shows dilated ureters with no apparent cause. Acid-fast bacilli on microscopic examination and culture of urine confirmed tuberculosis.

Mentions: In 3 out of the 12 cases, dilated ureters on IVU were likely to be a manifestation of tuberculosis (confirmed on urine examination) in our study, as no other signs suggestive of tuberculosis had been seen on either IVU or sonography. In 2 out of these 3 cases (having dilated ureters with no apparent cause on IVU), patients had presented with renal calculi and IVU had been requested preoperatively (Figure 1). Hence, urinary tract tuberculosis would have remained undiagnosed and untreated in these 3 cases, if they had not undergone a detailed clinicoradiological evaluation for the cause of ureteral dilatation (Figure 2).


Ureteral Dilatation with No Apparent Cause on Intravenous Urography: Normal or Abnormal? A Pilot Study.

Rathi V, Agrawal S, Bhatt S, Sharma N - Adv Urol (2015)

(a) Scout film shows a left renal calculus. An oval calcified node (arrow) lies outside the line of the ureter in (b). (b) Intravenous urogram shows dilated ureters with no apparent cause. Acid-fast bacilli on microscopic examination and culture of urine confirmed tuberculosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4631848&req=5

fig1: (a) Scout film shows a left renal calculus. An oval calcified node (arrow) lies outside the line of the ureter in (b). (b) Intravenous urogram shows dilated ureters with no apparent cause. Acid-fast bacilli on microscopic examination and culture of urine confirmed tuberculosis.
Mentions: In 3 out of the 12 cases, dilated ureters on IVU were likely to be a manifestation of tuberculosis (confirmed on urine examination) in our study, as no other signs suggestive of tuberculosis had been seen on either IVU or sonography. In 2 out of these 3 cases (having dilated ureters with no apparent cause on IVU), patients had presented with renal calculi and IVU had been requested preoperatively (Figure 1). Hence, urinary tract tuberculosis would have remained undiagnosed and untreated in these 3 cases, if they had not undergone a detailed clinicoradiological evaluation for the cause of ureteral dilatation (Figure 2).

Bottom Line: Extrinsic vascular compression and strictures did not appear to be clinically significant in our study.We conclude that ureteral dilatation with no apparent cause on IVU may indicate urinary tract tuberculosis, urinary tract infection (E. coli), or a missed calculus.Thus, cases with a dilated ureter on IVU, having no obvious cause, should undergo a detailed clinicoradiological evaluation and CTU should be used judiciously.

View Article: PubMed Central - PubMed

Affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India.

ABSTRACT
A pilot study was done in 18 adults to assess the significance of ureteral dilatation having no apparent cause seen on Intravenous Urography (IVU). A clinicoradiological evaluation was undertaken to evaluate the cause of ureteral dilatation, including laboratory investigations and sonography of the genitourinary tract. This was followed, if required, by CT Urography (using a modified technique). In 9 out of 18 cases, the cause of ureteral dilatation on laboratory investigations was urinary tract infection (6) and tuberculosis (3). In the remaining 9 cases, CTU identified the cause as extrinsic compression by a vessel (3), extrinsic vascular compression of the ureter along with ureteritis (2), extrinsic vascular impression on the right ureter and ureteritis in the left ureter (1), ureteral stricture (2), and ureteral calculus (1). Extrinsic vascular compression and strictures did not appear to be clinically significant in our study. Hence, ureteral dilatation without any apparent cause on intravenous urogram was found to be clinically significant in 12 out of 18 (66.6%) cases. We conclude that ureteral dilatation with no apparent cause on IVU may indicate urinary tract tuberculosis, urinary tract infection (E. coli), or a missed calculus. Thus, cases with a dilated ureter on IVU, having no obvious cause, should undergo a detailed clinicoradiological evaluation and CTU should be used judiciously.

No MeSH data available.


Related in: MedlinePlus