[Value of computer tomography in the staging of bladder and prostatic cancer]

In carcinomas of the urinary bladder we regard a humpy contour of the outer wall of the bladder as a transmural growth of the tumour, i.e. stage T4. A retraction of the wall or a plateau phenomenon was assigned to an intramural infiltration (stage T2 or T3). Contrary to the caudal lymphography in several cases changes in the nodes of the iliaca interna-group could be proved. The computer tomography seems to prove in such cases, in which the arteriography of the urinary bladder could not fulfil the expectations (9, 10). The results illustrate that by means of the methods chosen by us a delimitation of early invasive form paravesically growing vesical tumours is possible (12, 17, 18). In the classification of the carcinoma of the prostate the computer tomography does not give more essential informations in comparison to the rectal palpation, the vesiculography and the lymphography. The distinction of a normal prostate from the benign or malignant tumour tissue is not successful, since there are no specific differences in density. Particularly the tumour infiltration into the seminal vesicles could not be established early enough (7, 13). In the estimation of regional settlements of lymphatic nodes the statements are above all based on controls of the course, only a few cases could be ascertained histologically. In these cases it is necessary to keep in mind that in the computer tomography only lymphatic nodes from a diameter of 1.5-2 cm are recognizable. Since the computer tomography is a non-invasive method, it can be used for the pre- and postoperative diagnostics as well for controls of the course in tumour diseases of the lower urinary tract (2, 8, 20). However, no evidence can be made on the dignity of the spacial demands.