Urologic imaging and correlation with serum laboratory determinations in staging gynecologic malignancies

The records of 526 patients with gynecologic malignancies were reviewed to determine the correlation of urologic imaging modalities with serum renal function studies in detecting ureteral obstruction at the time of initial staging. Three hundred and forty-three of these patients had excretory urograms and 305 patients had concurrent serum urea nitrogen and creatinine determinations and 261 patients had concurrent radionuclide bone scans. Twenty-six patients had concurrent sonograms. Hydronephrosis (either unilateral or bilateral) was demonstrated at urography in 11% of patients with carcinoma of the cervix and ovary, but in only two percent of patients with carcinoma of the endometrium (the latter probably due to anatomic differences and an earlier stage of disease at the time of presentation). Serum urea nitrogen and creatinine determinations were abnormal in only 30% of the patients with urinary obstruction. Although only a small proportion of patients with hydronephrosis had bone scans and sonography, these appeared to be sensitive methods of detecting obstructions, but were more expensive than urography.