Nuwayrah Jawaid Saghir, Ishtiaq Ahmed Qureshi, Kiran Fatima Farooq, Mohammad Javaid Shah.
Intravenous urogram as a first line investigation in comparison with ultrasound.
Rawal Med J Jan ;38(1):44-7.

Objective The objective of this cross-sectional study was to evaluate the usefulness and efficacy of intravenous urogram in patients with urinary tract pathology detected on ultrasound and X-ray KUB. The duration of the study was from September 2007 to August 2009, a total of 250 patients were included; non probability purposive sampling technique was used. Methods Ultrasound scans and intravenous urograms were conducted by/under direct supervision of consultant radiologist; data obtained was entered on proforma; and analyzed statistically. Results A total of 254 patients were booked for the study; 4 patients were unable to complete the intravenous urogram due to reaction to the contrast medium; hence a total of 250 patients were included in the final study. There were 66 male and 184 female patients. Calculi (renal, ureteric and vesical) were seen in 139 patients, pelviureteric junction obstruction in 9, double collecting system and/or ureter in 6, neurogenic bladder in 13, horseshoe/pancake kidney in 2, ectopic kidney in 1, ureterocele in 2, cystocele in 1 and bladder mass in 7 patients. In 14 patients, the tests conducted were inconclusive and further investigations were advised. 28 patients had no detectable urinary tract pathology on any of the diagnostic modalities employed viz. ultrasound, X-ray KUB and intravenous urogram. Conclusions Intravenous urogram should not be performed routinely as a first line investigation in every patient presenting with flank pain. However, in congenital anomalies, intravenous urograms are needed and should be performed after a preliminary ultrasound.

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