The role of ultrasound and intravenous urography in evaluating patients with hematuria

Background and objective: Intravenous urography is a radiographic examination in which anatomic and physiologic abnormalities of the urinary tract are detected by obtaining a timed series of imaging of the abdomen and pelvis after the injection of intravenous "IV" iodinated contrast media. This study aimed to measure the diagnostic validity of ultrasound and intravenous urography in the hope of omitting unnecessary intravenous urography and to determine whether ultrasound could help to replace the intravenous urography in the diagnosis of hematuria. Patients and methods: A prospective hospital based study was performed from 15th April 2015 to 15th April 2016 on 100 patients presenting to Rizgary Teaching Hospital with hematuria, all patients underwent a real time ultrasound examination of the urinary tract followed by an intravenous urography. The diagnostic validities were recorded and compared for each modality. Results: Ultrasound had higher sensitivity than intravenous urography for diagnosis of kidney calculi, lower ureteric calculi, and urologic neoplasms, but in calculi of the middle and upper ureter, there was no difference between ultrasound and intravenous urography. Conclusion: Our results are in favor of using ultrasound in the initial evaluation of hematuria. However, we must choose our diagnostic tool according to the patient's condition and suspected disorders causing hematuria, as ultrasound can be safely done and hence minimizing the exposure of the patient and medical staff to excessive radiation.