The Role of CT Urography in the Evaluation of Adults Patients with Urological Manifestations at Muhimbili National Hospital

Abstract

CT urography is emerging to be the standard imaging tool for the evaluation of patients with urological manifestations such as hematuria and renal colic as it allows comprehensive evaluation of the upper and lower urinary tract. Accurate and prompt diagnosis is very crucial for best patient care hence imaging plays a major role. Broad Objective: This study aimed to determine the role of CT Urography in adult patients with urological manifestation at MNH from august 2020 to January 2021 Methodology: This study was a hospital-based descriptive retrospective and prospective study of adults aged 18 years and above. It was done at Muhimbili National Hospital in the Radiology Department using a structured data collection tool. The information obtained includes Socio-demographic information, clinical information, and CT Urography findings. Comparison of CTU results with other clinical results (Endoscopy: cystoscopy and ureteroscopy, open surgery and urinalysis and histopathological results (where available). Data analysis was done using SPSS and summarized using tables and figures. Results Study participants included were 106(54.1%) males and 90 (45.9%) females. The 2 most common symptoms were renal colic 156(79.6%) and hematuria 43(21.9%). CTU depicted many urinary tract abnormalities including renal stones 43 (21.9%), Ureteric stones 25(12.8%). Bladder stone 6(3.1%), solid renal mass 23(11.7%), bladder mass 8(4.1%), 95 cases of other urinary system disorders, and 24 extra-urinary findings. Among the 120 patients who underwent surgery, CTU correctly diagnosed all urinary tract stones 53 however one false positive was encountered (sensitivity 100%, specificity 98.5%) Conclusion CTU is a useful modality for detecting many urinary tract abnormalities. It has exceptional capabilities with high sensitivity and specificity in detecting urinary tract stones. In addition, vi CTU has the advantage of detecting extra-urinary and incidental findings which may not be suspected clinically. Recommendation Sensitization for prompt referral of patients with hematuria and renal colic to a specialized urological clinic for proper workup and management. CTU should be considered the primary imaging modality in the evaluation of high-risk patients with hematuria