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August 4, 1978

Preoperative Urography for Pelvic Masses

Author Affiliations

University of Colorado Medical Center Denver

JAMA. 1978;240(5):435. doi:10.1001/jama.1978.03290050025010

To the Editor.—  Included in the fine article "Gynecologic Radiology" by Wilhelm Z. Stern, MD (238:1763, 1977), are some of the ways in which excretion urography plays a role in evaluation of pelvic masses.It is also worth emphasizing that in the presence of a palpable mass, preoperative excretion urography is essential, since a pelvic ectopic kidney may be mistaken for a neoplasm of the ovaries, uterus,1 or mesentery.2 Furthermore, since renal ectopy is occasionally accompanied by absence of the contralateral kidney, inadvertant removal of or damage to an ectopic kidney can be disastrous.3Although preoperative ultrasonography is helpful in the evaluation of a pelvic mass and can often define a pelvic kidney, ectopic kidneys have been missed by this modality.4 The need for urography, therefore, is not obviated by previous sonography. Furthermore, the urogram not only can reveal urinary tract involvement by the mass but