Intravenous Pyelography and Renography in Patients with Cervical Carcinoma

Abstract

A total of 148 patients with carcinoma of the cervix were examinated by intravenous pyelogram (I. P.) and by radiohippuran I131 renography (R); it was observed that the radioisotope renogram (R) is more sensitive than the pyelogram in demonstrating renal or ureteral disfunction in patients with carcinoma of the cervix. The distribution of patients and the incidence of urinary complication for each stage were the following. STAGE I: 53 patients examinated; 2 (3,7%) patients had an abnormal I. P. whereas 15 (28,3%) showed an abnormal excretory phase (E) and 4 (7,5%) an abnormal secretory phase (S) in the radioisotope renograms. STAGE II: 34 patients examinated; none with an abnormal I. P., 17 (50%) with an abnormal (E) and 4 (11,7%) with an abnormal (S) in the renograms. STAGE III: 61 patients examinated; 13 (22,4%) presented an abnormal I.P. (in 6 patients no visualization of one kidney, in other 7 cases hydronephrosis was observed) whereas in 44 patients (72,1%) the renograms were abnormal in (E) and in 23 patients showed impairment of function (S). It was observed that the incidence of urinary tract complications of carcinoma of the cervix, observed by the radioisotope renogram, is in agreement with the incidence of treatment failures observed at the same stage I, II and III of 615 patients treated in this Institute during the years 1948-1957 inclusive. It is proposed to use the renogram method as a necessary study for an accurate staging, to reduce the number of relatively advanced carcinomas which are wrongly classified as stage I and to perform a more convenient treatment planning.