IS INTRAVENOUS UROGRAPHY INDICATED IN A YOUNG-ADULT WITH HEMATURIA

Objectives. Published reports are devoid of U.S. studies investigating the role of the intravenous urogram (IVU) in adult patients of differ ing ages with hematuria. To evaluate the efficacy of the IVU in patien ts less than 55 years old, a retrospective analysis was performed. Met hods. The records of all patients (n = 800) undergoing IVU in an inner city hospital from January 1991 through October 1994 were reviewed fo r age, gender, race, urinalysis data, and cystoscopic and biopsy findi ngs. Age greater than 55 years, recent trauma, and known malignancy we re exclusion criteria. Hematuria was the indication for IVU in 128 of 800 patients. Eight (6.2%) of 128 patients had inadequate chart inform ation, leaving a total of 120 evaluable charts. Results. We stratified the 120 patients by age, degree of hematuria (gross versus microscopi c), and gender. The younger group (17 to 40 years old) included 64 pat ients (53%) and the older group (41 to 55 years old) 56 patients (47%) . Gross hematuria was reported in 65 patients (54%), whereas 55 (46%) had microscopic hematuria. Men accounted for 78 patients (65%) and wom en for 42 (35%). The majority of patients were African-Americans (100 [83%] of 120). Abnormal findings were seen in 17 (14%) of 120 patients . The IVU alone provided no diagnosis of immediate consequence. There was no significant-difference in findings between the age groups (P = 0.61), gross and microscopic hematuria (P = 0.28), and men and women ( P = 0.59). Contrast reactions occurred in 3 (2.5%) of 120 patients. Co nclusions. In this inner city population younger than 55 years of age, the usefulness of the IVU for the evaluation of hematuria is question able. It did not establish a diagnosis, modify the subsequent evaluati on, or change the therapy in any of our patients.