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  IN THIS Article
 ::  Introduction
 ::  Material and methods
 ::  Results
 ::  Discussion

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Year : 1987  |  Volume : 33  |  Issue : 3  |  Page : 115-6

Vesical calculus : is an intravenous urography necessary?







How to cite this article:
Chopra P S, Suleman S S, Shrestha M M, Sobti M M. Vesical calculus : is an intravenous urography necessary?. J Postgrad Med 1987;33:115


How to cite this URL:
Chopra P S, Suleman S S, Shrestha M M, Sobti M M. Vesical calculus : is an intravenous urography necessary?. J Postgrad Med [serial online] 1987 [cited 2020 Oct 21];33:115. Available from: https://www.jpgmonline.com/text.asp?1987/33/3/115/5280




  ::   Introduction Top

Vesical calculi in children and adults are still a common problem in India. Although most surgeons carry out an intra-venous urogram (I.V.U.) in all patients with upper urinary tract calculi, all of them do not do so in patients with vesical calculi. During one of the weekly inter-departmental meetings (Urology and Radiology), we saw a patient in whom the vesical calculus had been treated endoscopically while a hyper-nephroma was all but missed till we did an I.V.U. on him. The chief of Urology then suggested that we look up our records and find out what proportion of cases with vesical calculi, which had an I.V.U., were found to have additional urological abnormalities. This paper describes the findings of that study.

  ::   Material and methods Top

The Department of Radiology has maintained files of all I.V.U.s done in the department since 1-1-83, thus, upto 15-2-87, 5020 I.V.U.s were available for scrutiny. We could find from these records 43 cases in which an I.V.U. was done because of a vesical calculus. Their files were analysed for other abnormalities of the urinary tract detected on I.V.U.

  ::   Results Top

There were 38 adults (34 males and 4 females) and 5 male children (upto the age of 12). The findings of the study are shown in [Table 1]. Thirty-six of the 43 patients had one or more abnormalities in the urinary tract. (In addition to the vesical calculus). All 5 children had an abnormal I.V.U. Vesico-ureteric reflux was present in 3 out of 5 children, but in only 4 out of 38 adults. Other than procidentia, vesico-vaginal fistula and prostatic hypertrophy, no other abnormality showed an age or sex bias.

  ::   Discussion Top

Eighty four per cent of patients with vesical calculi who had an I.V.U. showed one or more abnormalities in the urinary tract in addition to the vesical calculus. Barring fibrolipomatosis, all other abnormalities deserved further investigation, close follow up and/or surgical correction. Except for the vesico-ureteric refluxe and the sex related abnormalities, others showed no age or sex bias. This suggests that all patients with vesical calculus should have an I.V.U.
The presence of renal or ureteric calculus, Poor contrast excretion, pelvicaliectasis or hydroureter suggest that the vesical calculus has decended from the kidney. There were 13 such cases in this study. In 15 cases (primary vesical calculi) the probable cause of the vesical calculus lay in the distal urinary tract, prostatic hypertrophy, posterior urethral valves, vesico-vaginal fistula and cystocele. In the remaining 15 cases, we could not decide whether the calculus formed in the bladder or descended from above. Vesico-ureteric reflux has may causes one of which is a vesical calculus.
It would appear that polycystic kidneys, hypernephroma, parapelvic cyst and fibrolipomatosis of the renal sinus were unexpected findings, although all except fibrolipomatosis needed additional treatment.

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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow