Recurrent upper tract urothelial tumours: the use of loopography following cystectomy for bladder cancer

Br J Radiol. 1994 Nov;67(803):1057-61. doi: 10.1259/0007-1285-67-803-1057.

Abstract

Recurrent upper tract tumours following cystectomy for transitional cell carcinoma are not uncommon. Conventional follow-up to identify preclinical recurrent disease often involves a combination of excretory urography and urine cytology. This study investigates the possible advantages of loopography in the follow-up of these patients. 41 patients who had undergone cystectomy and ileal loop diversion for transitional cell carcinoma of the bladder were studied. At the time of evaluation with a loopogram, eight out of 41 (19.5%) were symptomatic. Loopography was well tolerated by all of the patients with no reported side-effects or complications from the procedure. Six out of 41 (14.6%) of the loopograms demonstrated an abnormality with recurrent transitional cell carcinoma identified in two patients. In only one case was excretory urography necessary where a ureteric stricture prevented retrograde imaging of the upper tract. Loopography is a safe and well-tolerated investigation for the follow-up of these patients. Excretory urography should be reserved for cases where upper tract imaging is impaired because of obstruction within the loop or ureters.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell / diagnostic imaging
  • Carcinoma, Transitional Cell / surgery*
  • Cystectomy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Radiography
  • Reoperation
  • Retrospective Studies
  • Ureteral Obstruction / diagnostic imaging
  • Urinary Bladder Neoplasms / surgery*
  • Urinary Diversion*