RECURRENT UPPER TRACT UROTHELIAL TUMORS - THE USE OF LOOPOGRAPHY FOLLOWING CYSTECTOMY FOR BLADDER-CANCER

Recurrent upper tract tumours following cystectomy for transitional ce ll carcinoma are not uncommon. Conventional follow-up to identify prec linical recurrent disease often involves a combination of excretory ur ography and urine cytology. This study investigates the possible advan tages of loopography in the follow-up of these patients. 41 patients w ho had undergone cystectomy and ileal loop diversion for transitional cell carcinoma of the bladder were studied. At the time of evaluation with a loopogram, eight out of 41 (19.5%) were symptomatic. Loopograph y was well tolerated by all of the patients with no reported side-effe cts or complications from the procedure. Six out of 41 (14.6%) of the loopograms demonstrated an abnormality with recurrent transitional cel l carcinoma identified in two patients. In only one case was excretory urography necessary where a ureteric stricture prevented retrograde i maging of the upper tract. Loopography is a safe and well-tolerated in vestigation for the follow-up of these patients. Excretory urography s hould be reserved for cases where upper tract imaging is impaired beca use of obstruction within the loop or ureters.