Excretory urography in patients with prostatism

Area of Science:

• Urology
• Diagnostic Imaging

Background:

• Prostatism is common in men over 50.
• Benign prostatic hypertrophy (BPH) is a frequent finding.
• Routine screening methods for complications of prostatism are debated.

Purpose of the Study:

• To evaluate the diagnostic yield of routine screening excretory urography (EU) in patients presenting with prostatism.
• To determine if EU alters patient management in this specific cohort.

Main Methods:

• Prospective evaluation of 180 male patients aged 50 years or older with symptoms of prostatism or acute urinary retention.
• Exclusion of high-risk patients (hematuria, UTIs, history of bladder tumors, elevated creatinine).
• Performance of excretory urography for all included patients.

Main Results:

• Excretory urography findings led to a change in patient management in 4 out of 180 patients (2.2%).
• Three patients were diagnosed with asymptomatic upper urinary tract malignancies.
• One patient was found to have a complicated renal cyst.

Conclusions:

• Routine screening excretory urography is warranted in select patients with prostatism.
• EU can detect significant, asymptomatic upper tract pathology in this population.
• The diagnostic yield justifies its use despite excluding high-risk individuals.