Utility of ultrasound of the upper urinary tract in elderly men with indicators of obstructive symptoms or abnormal flow: how often can silent hydronephrosis be detected in general practice?

Abstract

While the prevalence of hydronephrosis is very low in obduction studies, a prevalence of 3-13% is reported for patients with an obstruction who are listed for prostatectomy. In order to evaluate the usefulness of transabdominal ultrasound in primary care, we determined the occurrence of hydronephrosis in males with symptoms of urinary obstruction in a general practice setting. A micturition questionnaire (a modified Boyarsky) was sent to all men of 55 years or more who were registered in 10 general practices in Maastricht, and was followed by an examination at their general practice. Men with obstructive symptoms and/or with a free-flow abnormality were examined in the hospital with transabdominal ultrasound in order to detect dilatation of the upper urinary tract. This ultrasound was repeated approximately 15 months later. At the first measurement, none of the examined men (n = 178) had hydronephrosis, and this was still the case for 94 men 15 months later. Renal ultrasound is not necessary in general practice for men with uncomplicated obstructive complaints.