DOES BOWEL PREPARATION IMPROVE THE QUALITY OF INTRAVENOUS UROGRAPHY

Many radiology departments continue to use bowel preparation prior to intravenous urography (IVU) despite recent studies questioning its val ue. This prospective study was designed to test the hypothesis that bo wel preparation does not affect the quality of IVU, the number of film s taken, or the use of tomography. 144 patients were randomized into t hree groups; 49 had no preparation, 48 received a mild stimulant laxat ive (Dulcolax), and 47 took an osmotic laxative (Citramag). The subseq uent IVUs were then reviewed by two observers; the control and contras t films were scored for the presence of faecal residue, and the visibi lity of the renal tract, respectively. Patients were also questioned a bout the side effects of the two preparations. There was no significan t difference in the scores for renal tract visibility in those patient s receiving stimulant laxative when compared with the unprepared group . Those receiving the osmotic laxative had significantly less faecal r esidue but this was at the expense of an increased amount of bowel gas . The osmotic laxative group had significantly higher scores, indicati ng better visualization of the urinary tract, than the other groups, b ut no significant reduction in the number of radiographs taken or the use of tomography. This group also reported more side effects. Overall our results suggest that the routine use of a laxative prior to an IV U examination does not decrease the radiation dose and produces some p atient inconvenience. The practice therefore cannot be routinely recom mended.