Why is urography necessary in patients with urothelial cancer of the urinary bladder?
Urothelial cancer (UC) is 50 times more common in the urinary bladder than in the upper urinary tract. UC is a multifocal process, however, and upper urinary tract involvement occurs in approximately 5% of patients with bladder cancer, either synchronously at the time of bladder cancer diagnosis, or in a metachronous fashion. The upper urinary tract of patients with bladder cancer must be kept under close surveillance, usually with periodic urograms. Patients with upper urinary tract UC have a 30% to 40% incidence of UC involving the opposite side. Treatment of upper tract UC is typically with nephroureterectomy, sometimes along with regional lymph node dissection, although segmental or endoscopic resection may be performed in selected cases. Chemotherapy is generally utilized when metastatic disease is present.
