TRANSABDOMINAL AND ENDOLUMINAL ULTRASONIC-SCANNING OF THE LOWER URETER

I.v. urography is often insufficient for visualization of the intramur al and juxtavesical portion of the ureter. In 30 consecutive patients (July 1st 1993 - January 31st 1994) where i.v. urography was inconclus ive, but had evoked suspicion of pathology in - or adjacent to - the l ower ureter, abdominal ultrasound (including color Doppler) and endolu minal (transrectal or - vaginal) ultrasound were performed. A final di agnosis was obtained in 26 : Ureteric stone (14), prostatic cancer (4) , bladder cancer (2), stricture of ureteric orifice (1), TURB sequelae (1), ureterocele (1), bladder stone (1), detrusor hypertrophy (1), no rmal ureter (1). Abdominal ultrasound scanning gave more, same, and le ss information than i.v. urography in 8, 8, and 10 cases, respectively . In 14 of 22 cases abdominal color Doppler revealed a unilateral abno rmal ''ureteral jet'' - in 13 of the cases on the side with suspected obstruction. Endoluminal ultrasound scanning gave more, same, and less information than i.v. urography in 20, 4, and 2 cases, respectively. The 20 cases where endoscanning gave more information included detecti on of 14 distal ureteric stones. In 3 cases it identified other types of distal obstruction, in two cases it determined the length of cancer obstruction and in one it detected the presence of ureteral dilatatio n. It is concluded, that endoluminal ultrasound of the ureter is indic ated when i.v. urography evokes suspicion of pathology in the intramur al or juxtavesical part of the ureter.