Renal sonography in the diagnosis of renal obstruction or hydronephrosis in patients with cervical cancer

Purpose. The aim of this prospective study was to evaluate the role of renal sonography and its use as an alternative to intravenous urography in detecting ureteral obstruction or hydronephrosis in patients with cervical cancer. Materials and Methods. Patients with biopsyconfirmed carcinoma of the cervix who were referred to the radiotherapy center from February 6, 2001, through July 20, 2001, were enrolled in this trial. All patients had previously undergone clinical staging by physical examination and either intravenous urography or CT scanning as the standard tests for diagnosing ureteral obstruction or hydronephrosis. All patients underwent renal sonography as an alternative diagnostic tool for diagnosing ureteral obstruction or hydronephrosis. Results. Forty patients were enrolled. Their mean age was 46 years (range, 26-65 years). According to the FIGO staging system, 12% of the patients had clinical stages 1B2 and 2A disease, 20% had stage 2B, 8% had stage 3A, 50% had stage 3B, and 10% had a postoperative recurrence of cervical cancer. Thirty-four patients had had intravenous urography and 6 had had CT scans of the abdomen and pelvis. Sensitivity, specificity, positive and negative predictive values and overall accuracy rates for renal sonography were 76.5% (13/17), 100% (23/23), 100% (13/13), 85% (23/27), and 90% (36/40), respectively. Seventy-five percent (3/4) of the false-negative results occurred in patients with pelvic sidewall thickening on physical examination. Conclusions. Renal sonography may be used as an effective and relatively low-cost means of diagnosing ureteral obstruction in patients with cervical cancer without clinically evident pelvic sidewall thickening. © 2002 Wiley Periodicals, Inc.