Excretory urography and computed tomography in the initial evaluation of patients with cervical cancer: are both examinations necessary?

One hundred ten patients with carcinoma of the cervix were studied to determine if both excretory urography and computed tomography are needed for routine evaluation. Computed tomography gave more information in 25 patients and the excretory urogram was more informative in 10 patients. Thirty-five hydroureters were detected by computed tomography, whereas excretory urography identified 21. The hydroureter in its entirety was seen more often using computed tomography, and the site of obstruction was identified in 29 of 35 cases. The superiority of computed tomography was particularly evident in patients with stage IIB or more advanced lesions. In stage I-IIA lesions, both techniques yielded the same information about the urinary tract. It was concluded that routine use of both examinations is not indicated. Excretory urography is currently sufficient in evaluation of stage I or IIA lesions, while computed tomography obviates excretory urography in patients with advanced cervical cancer (IIB-IVB).