Role of Computed Tomography Urography in Evaluation of Patients with Obstructive Uropathy

Abstract

Introduction: CT urography plays an important role in the diagnosis of many diseases of urinary tract and is one of the most advanced developments in uroradiology. The aim of the study is to evaluate role of CT urography in patients presenting with obstructive uropathy and finding its cause and level of obstruction.

Methods: This was a descriptive cross sectional study conducted in Department of Radio-diagnosis in Lumbini Medical College, Palpa, Nepal from  June 1st, 2021 to May 31^st  2022 .150 patients were enrolled presenting with unilateral or bilateral hydronephrosis diagnosed on ultrasound and were referred for CT urography for the cause and level of obstruction.

Results: Most common cause of urinary obstruction was due to calculus seen in 115 patients (76.7%).  PUJ obstruction was seen in 17 patients (11.3%). Extrinsic ureteric obstruction was seen in six cases (4.0%). Ureteric stricture was found in five patients (3.3%). Urinary bladder mass was seen in four patients (2.7%). In three cases one was due to congenital anomaly and two cases were of ectopic ureter insertion. The most common level of obstruction was pelvis found in 50 patients (33.4%). PUJ obstruction was found in 47 patients (31.3%).  20 patients had upper ureter obstruction (13.3%). Distal ureter obstruction was found in 13 patients (8.7%) followed by VUJ obstruction of 10 patients (6.7%). Mid ureter obstruction was the least common site as found in eight patients (5.3%).

Conclusion: CT urography is a modality for evaluating urinary tract abnormalities, especially for obstructive uropathy. Our results showed it is exceptional in diagnosing cause and level of obstruction. The most common cause was stone and most common level was pelvis.