The significance of double contrast retrograde urethrocystography in prostatic tumors

ABSTRACT

DRUC( Double Contrast Retrograde Urethrocystography), which was a combination of air cystography andretrograde urethrography with the patient in an exaggerated Trendelenburg's position allowing the contrast mediuminjected into bladder to be accumulated at the bladder base and dome far from trigone, showed good visualization of the prostatic urethra, bladder neck, bladder base and wall in contrast to the conventional, retrogradeurethrography. The authors analyzed DRUC findings of 32 cases of benign prostatic hypertrophy, 3 case of prostaticcancer and 50 cases of normal healthy men performed at Pusan National University Hospital for 9 months from Jan.1984 to Sept. 1984. The results obtained were as follows 1. DRUC findings of normal control group were normalpattern of prostatic urethra, semioval shaped bladder wall. 2. DRUC findings of B.P.H. were spreading of prostaticurethra, spreading, displacement, smooth multidirectional compression of bladder neck, widening of inner orificeof bladder neck, smooth elevation of bladder base, traveculation of bladder wall and variable type of intravesicalstream such as normal, broad, double central stream, associated peripheral umbrella stream and no intravesicalstream. 3. DRUC findings of prostatic cancer were rigidity of prostatic urethra, nodular multidirectionalcompression of bladder neck, multiseptation of peripheral intravesical stream, nodularity of bladder base andtrabeculation of bladder wall. 4. DRUC, which added to double contrast method and postion change of patient,showed more delicate changes of baldder neck, base and wall as well as prostatic urethra in contrast to simpleRUG. We observed that changes of bladder neck and intravesical stream were significant in analzing abnormalenlarged prostate, and could differentiate B.P.H. from prostatic cancer simply by noting sharply demarcatedbladder base.