Intravenous contrast media in uroradiology: evaluation of safety and tolerability in almost 50, 000 patients

To evaluate the frequency of adverse events and possible risk factors after the administration of an intravenous contrast medium [CM], iobitridol, in a large multicentre postmarketing surveillance study. A total of 49,975 patients undergoing intravenous urography were included in this study. A water-soluble, non-ionic CM [iobitridol, 1 ml/kg body weight] was administered. Age, sex, indication for the actual examination and adverse events were documented. Also, high-risk patients were identified. Of the 49,975 patients, 28,336 [56.7%] were males and 21,639 [43.3%] females. Indications for urography were mainly urolithiasis [39.1%], inflammatory diseases [25.6%] and tumours [13.9%]. Additionally, 7.4% were risk patients: 1.9% with creatinine >1.5 mg/dl [0.1% were on haemodialysis]; 0.8% had a history of previous allergic reactions to CM, 3.7% pre-existing asthma or allergies and 2% other risk factors against CM examination. Only 0.9% of the patients experienced acute adverse events that were non-serious and transient. Less than 0.1% of the patients experienced vomiting, dizziness or cardiovascular problems. Only 1 patient developed an anaphylactic shock but recovered fully under treatment. A 2 analysis revealed that adverse reactions occurred in patients with pre-existing renal insufficiency or allergies. Significantly more females had contrast-agent-related symptoms compared to men. Patients undergoing urography for urolithiasis had significantly fewer symptoms compared to patients with other indications. Iobitridol is clinically safe and well tolerated in urography as demonstrated in this study of a large patient population, producing mainly minor symptoms as adverse events. However, caution is advised when administering iobitridol to high-risk patients

Diverticular carcinoma of the urinary bladder: diagnosis and treatment problems. A case report

To report a case of a primary carcinoma arising in a vesical diverticulum. Clinical Presentation and Intervention: A 59-year-old male patient presented with painless macrohematuria. A primary carcinoma arising in a vesical diverticulum was detected with cystoscopy and confirmed with rectal endosonography and computer tomography. and radical cystoprostatovesiculectomy with ileal conduit was performed. Chemotherapy with cisplatin and methotrexate followed. The patient died of an acute cardiac event in the 4th postoperative month.This report illustrates that in a case of a closed opening of a bladder diverticulum, rectal endosonography and computer tomography do provide additional support for making a diagnosis of a hidden tumor in the diverticulum