The value of cystoscopy and intravenous urography after magnetic resonanceimaging or computed tomography in the staging of cervical carcinoma

The clinical staging system for cervical carcinoma presently recommended by the international Federation of Gynecology and Obstetrics (FIGO) does not include MRI or CT findings and thus suffers limited accuracy. Recently howe ver, the positive contributions of MRI and CT to preoperative staging have been reported. This study involves a determination of the value of routine cystoscopy and intravenous urography, in the detection of bladder invasion or hydronephrosis resulting from cervical carcinoma, among patients who had undergone MRI or CT. Among a total 296 patients with cervical carcinoma, 2 71 patients (92%) had undergone MRI and 25 (8%) CT. Bladder invasion was id entified pathologically by cystoscopic biopsy in 8 (57%) of the 14 patients with suspected bladder invasion on MRI or CT. There was no bladder invasio n in any of the other cases lacking in bladder invasion evidence on MRI or C-T. Hydronephrosis was identified by intravenous urography in 18 patients, as it also was in all of these cases on MRI or CT, confirming a negative p redictive value for MRI or CT, in detecting bladder invasion or hydronephro sis from cervical carcinoma, of 100%. Therefore, although MRI or CT cannot totally replace cystoscopy, the latter is unnecessary in the absence of bla dder invasion evidence on MRI or CT. Intravenous urography, however, can be safely omitted whenever NRI or CT is performed.