UTILITY OF CHEST RADIOGRAPHY AND CYSTOSCOPY IN THE EVALUATION OF PATIENTS WITH LOCALIZED PROSTATE-CANCER

Objectives, Candidates for radical prostatectomy have been frequently evaluated with chest radiography and occasionally with cystoscopy. The utility of these studies was assessed. Methods. A retrospective revie w of 236 cases of radical prostatectomy performed over 5 years was con ducted. Chest x-ray results were correlated with certain comorbidities believed to be risk factors for radiographic abnormalities, including hypertension, cardiac disease, pulmonary problems, and tobacco use. C ystoscopic findings were analyzed with regard to urologic history and urinalysis results. Results. Chest radiography was normal in 208 (88.1 %) and abnormal in 28 (11.9%) patients. All 28 patients with abnormali ties had one or more of the aforementioned risk factors. Sixty-two ind ividuals (26.3%) had no risk factors, and chest radiography was unifor mly normal in this group. Cystoscopy was performed in 91 patients. Sta ge Ta transitional cell carcinoma of the bladder was detected in 6 of these patients (6.6%); these 6 patients ail had either a history of th is problem or hematuria; One individual had a mild bladder-neck contra cture that did not warrant treatment. Endoscopic findings were normal in the remaining patients. Conclusions, Chest radiography is not routi nely needed to evaluate radical prostatectomy candidates. It should on ly be performed in patients who have or are at risk for cardiopulmonar y disease. Cystoscopy is not warranted in this setting unless there is clinical suspicion of other urologic pathology.