In this study 171 consecutive patients hospitalized for prostatectomy were prospectively evaluated by urologist-performed transabdominal ultrasound. The urologist-sonographers were blinded to the results of an excretory urogram (IVP) performed and interpreted by radiologists. All significant upper tract pathology (4 renal cell carcinomas and 1 transitional cell carcinoma of the renal pelvis) identified by an IVP also was detected by ultrasonography. Of 5 clinically silent stones seen on an IVP 4 were identified by sonography. There were 13 patients (7.6%) with severe contrast medium allergies or renal failure who were readily evaluated with ultrasonography. Urologist-performed sonography can safely replace an IVP for routine evaluation of the urinary tract before prostatectomy. Moreover, sonography provided significant additional data on prostate size and post-void residual. However, the cost-effectiveness of upper tract imaging in patients before prostatectomy may be questioned.
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