Virtual endoscopy in the diagnosis of upper urinary tract pathologies

Introduction: Upper urinary tract pathology is often a diagnostic challenge for the urologist. We have witnessed rapid development of new computed tomography hardware and software that has led to technical improvements, as set out in this report. Materials and methods: We included 57 computed tomography urographies (Uro-CT) done between January 2005 and August 2007 in our hospital. Patients included were suspected to suffer upper urinary tract pathology. We collected indications, the results of this test and compared their internal validity values with those of the conventional radiological explorations. Results: We made 57 explorations in 56 patients with a mean age of 56 years (range 38-84). The results were: 21 lithiases, 8 urothelial neoplasms, 2 pelvic neoplasms, 3 ureteral neoplasms and 3 vesical neoplasms. We diagnosed hydronephrosis of uncertain etiology in all patients suffering from it (6 patients). We also found 2 lithiases in patients with urinary diversions and 5 benign stenoses. Lastly, we found different congenital malformations. Internal validity values were higher than those from conventional radiological explorations. Conclusions: Uro-CT is a cost-effective exploration, available in almost every medical centre. It allows an improvement in the detection rate of upper urinary tract pathologies.