Should the followup of patients with bladder cancer include routine excretory urography?

This retrospective study was done to determine if patients who present with bladder tumors should be followed with routine excretory urograms to detect subsequent upper tract tumors at an early stage. The charts of 337 patients who have been followed for up to 9 years were reviewed. Excluding 1 patient with invasive transitional cell carcinoma of the distal ureter, no documented renal pelvic or ureteral tumor was discovered in any of the followup data. This finding is in contradistinction to patients who present with upper tract tumors and who are known to have a 44 to 54 per cent incidence of bladder tumor either pre-dating or post-dating the upper tract tumor. We conclude that routine excretory urography is neither cost-effective nor necessary for the followup of patients who present with bladder tumors.