Excretory urography in patients with prostatism

The value of performing routine screening excretory urography in patients with prostatism was prospectively evaluated in 180 patients (50 years old or older). All patients had signs and symptoms of prostatism or acute urinary retention, findings of benign prostatic hypertrophy on physical examination, and negative urine cultures. High-risk patients, such as those with hematuria, urinary tract infections, history of bladder tumors, or significant elevation of serum creatinine, were excluded. In four patients (2.2%), findings of excretory urography resulted in an alteration of patient management. Three of these had asymptomatic upper urinary tract malignancies. One had a complicated renal cyst. We conclude that routine screening of patients with prostatism is warranted.