David L. Simel, MD; Joanne Piscitelli, MD; David B. Matchar, MD
To the Editor: We concur with the recommendations offered by Drs. Mushlin and Thornbury (1) concerning the routine use of intravenous pyelography before hysterectomy. Although no studies were cited that provided information about women with large pelvic masses, our reports (2, 3) provide specific results for subgroups of patients for which selected use of intravenous pyelography might be reasonable. Findings from the gynecologic examination most likely associated with ureteral abnormalities among women having a hysterectomy for nonmalignant disease include uterine size of 12 weeks gestational age or larger or an adnexal mass 4 cm or larger. Endometriosis, pelvic inflammatory disease,
Simel DL, Piscitelli J, Matchar DB. Intravenous Pyelography before Hysterectomy. Ann Intern Med. ;111:541. doi: 10.7326/0003-4819-111-6-541_1
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Published: Ann Intern Med. 1989;111(6):541.
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