The excretory urogram bowel preparation--is it necessary?

A prospective randomized study was undertaken to determine whether prior bowel preparation improves the diagnostic quality of the excretory urogram. From August 1986 to May 1987, 107 outpatients having an excretory urogram on an elective basis were randomized into 3 groups: group 1 received castor oil, group 2 received x-ray preparation and group 3 received clear fluids 24 hours before the study. The quality of the bowel preparation and the excretory urogram was graded separately on a scale of 1 to 5. More than 71 per cent of the bowel preparations were graded as 4 (very good) or 5 (excellent) and more than 91 per cent of the films were graded as 4 or 5 in all 3 groups. The quality of the excretory urogram was graded as 5/5 in a greater number of group 3 cases. Patients reported a high incidence of side effects from both bowel preparations, while no adverse effects were reported from those in group 3. The administration of a bowel preparation compared to that of clear fluids alone made no difference to either the quality of the bowel preparation or the diagnostic quality of the film.