Efficacy of the excretory urogram in the staging of gynecologic malignancies

It is common for patients suspected of having a gynecologic malignancy to be referred for excretory urography as part of their preoperative staging evaluation. This study investigates the efficacy of this practice using prospective and experimental retrospective interpretations of 88 urograms obtained for this clinical indication. The results indicate that excretory urography reliably depicts the ureters in most cases. However, the urogram is quite insensitive (sensitivity, 7%-33% among the interpretation settings) in demonstrating the extension of malignancy; specificity for this purpose was 79%-97%. The excretory urogram is useful for locating the position of the ureters and demonstrating the presence of obstruction or unsuspected urinary tract abnormalities. Nonetheless, this information also may be obtained by computed tomography, which can more accurately assess the primary mass and indicate the presence of malignant extension.
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