Ureteroscopic Treatment of Upper Tract Neoplasms

  • Demetrius H. Bagley
Part of the Current Clinical Urology book series (CCU)

Abstract

Ureteroscopy is an esential step in the diagnosis and treatment of upper tract neoplasms. Most filling defects in the upper tract require endoscopic visualization and biopsy to direct treatment. Ureteroscopic treatment has had excellent success and a high recurrence rate and persistence of good renal function. Endoscopic surveillance is necessary to detect recurrences when they are small. Ureteroscopic tumor treatment includes mechanical removal, fulguration, and laser coagulation and resection. Large, extensive, and high-grade neoplasms may not be amenable to ureteroscopic treatment and can require percutaneous treatment or nephroureterectomy.

Key Words

Ureteroscopy neoplasms ureter intrarenal neoplasms lasers biopsy endoscopy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Huffman JL, Bagley DH, Lyon ES, Morse MJ, Herr HW, Whitmore Jr. WF: Endoscopic diagnosis and treatment of upper tract urothelial tumors: a preliminary report. Cancer 1985; 55: 1422–1428.PubMedCrossRefGoogle Scholar
  2. 2.
    Dretler SP, Cho G: Semirigid ureteroscopy: a new genre. J Urol 1989; 141(6): 1314–1316.PubMedGoogle Scholar
  3. 3.
    Abdel-Razzak OM, Bagley DH: The 6.9F semi-rigid ureteroscope in clinical use. Urology 1993; 41(1): 45–48.PubMedCrossRefGoogle Scholar
  4. 4.
    Bagley DH, Rittenberg MH: Intrarenal dimensions: guidelines for flexible ureteropyeloscopes. Surg Endosc 1987; 1: 119–121.PubMedCrossRefGoogle Scholar
  5. 5.
    Bagley DH: Ureteroscopic stone retrieval: rigid versus flexible endoscopes. Sem Urol 1994; 12: 32–38.Google Scholar
  6. 6.
    Lobik L, Lopez-Pujals A, Leveillee RJ. Variables affecting deflection of a new third-generation flexible ureteropyeloscope (DUR-8 Elite). J Endourol 2003; 17: 733–736.PubMedCrossRefGoogle Scholar
  7. 7.
    Johnson GB, Grasso M: Exaggerated primary endoscope deflection initial clinical experience with prototype flexible ureteroscopes. BJU Int 2004; 93: 109–114.PubMedCrossRefGoogle Scholar
  8. 8.
    Abdel-Razzak OM, Ehya H, Cubler-Goodman A, Bagley DH: Ureteroscopic biopsy in the upper urinary tract. Urology 1994; 44(3): 451–457.PubMedCrossRefGoogle Scholar
  9. 9.
    Bagley DH: Ureteroscopic laser treatment of upper urinary tract tumors. J Clin Laser Med Surg 1998; 16 (1): 55–59.PubMedGoogle Scholar
  10. 10.
    Razvi HA, Chun SS, Denstedt JD, Sales JL: Soft-tissue applications of the holmium:YAG laser in urology. J Endourol 1995; 9: 387–390.PubMedGoogle Scholar
  11. 11.
    Tawfiek ER, Bibbo M, Bagley DH: Ureteroscopic biopsy: technique and specimen preparation. Urology 1997; 50: 117–119.PubMedCrossRefGoogle Scholar
  12. 12.
    Keeley FX Jr, Bibbo M, Bagley DH. Ureteroscopic treatment and surveillance of upper urinary tract transitional cell carcinoma. J Urol 1997; 157: 1560–1565.PubMedCrossRefGoogle Scholar
  13. 13.
    Schmeller NT, Hofstetter AG. Laser treatment of ureteral tumors. J Urol 1989; 141: 840–843.PubMedGoogle Scholar
  14. 14.
    Blute ML, Segura JW, Patterson DE: Impact of endourology on diagnosis and management of upper urinary tract urothelial cancer. J Urol 1989; 141: 1298–1301.PubMedGoogle Scholar
  15. 15.
    Johnson DE. Treatment of distal ureteral tumors using endoscopic argon photoirradiation. Lasers Surg Med 1992; 12: 490–493.PubMedCrossRefGoogle Scholar
  16. 16.
    Grossman HB, Schwartz SL, Konnak JW. Ureteroscopic diagnosis and treatment of urothelial carcinoma of the ureter and renal pelvis. J Urol 1992; 148: 275–277.PubMedGoogle Scholar
  17. 17.
    Tasca A, Zattoni F, Garbeglio A, et al. Endourologic treatment of transitional cell carcinoma of the upper urinary tract. J Endourol 1992; 6: 253–256.Google Scholar
  18. 18.
    Kaufman RP Jr., Carson CC 3rd. Ureteroscopic management of transitional cell carcinoma of the ureter using the neodymium:YAG laser. Lasers Surg Med 1993; 13: 628.CrossRefGoogle Scholar
  19. 19.
    Gaboardi E, Bozzola A, Dotti E, et al. Conservative treatment of upper urinary tract tumors with Nd:YAG laser. J Endourol 1994; 8: 37–41.PubMedGoogle Scholar
  20. 20.
    Bales GT, Lyon ES, Gerber GS. Conservative management of transitional cell carcinoma of the kidney and ureter. Diagn Ther Endosc 1995; 1: 121–123.CrossRefPubMedGoogle Scholar
  21. 21.
    Engelmyer EI, Belis JA. Long-term ureteroscopic management of low-grade transitional cell carcinoma of the upper urinary tract. Tech Urol 1996; 2: 113–116.PubMedGoogle Scholar
  22. 22.
    Elliott DS, Blute ML, Patterson DE, et al. Long term follow-up of endoscopically treated upper urinary tract transitional cell carcinoma. Urology 1996; 47: 819–825.PubMedCrossRefGoogle Scholar
  23. 23.
    Martinez-Pineiro JA, Garcia Matres MJ, Martinez-Pineiro L. Endourological treatment of upper tract urothelial carcinomas: analysis of a series of 59 tumors. J Urol 1996; 156: 377–385.PubMedCrossRefGoogle Scholar
  24. 24.
    Patel A, Fuchs GJ. New techniques for the administration of topical adjuvant therapy after endoscopic ablation of upper urinary tract transitional cell carcinoma. J Urol 1998; 159: 71–75.PubMedCrossRefGoogle Scholar
  25. 25.
    Grasso M, Fraiman M, Levine M. Ureteroscopic diagnosis and treatmentn of upper urinary tract urothelial malignancies. Urology 1999; 54: 240–246.PubMedCrossRefGoogle Scholar
  26. 26.
    Chen GL, Bagley DH. Ureteroscopic management of upper tract transitional cell carcinoma in patients with normal contralateral kidneys. J Urol 2000; 154: 1173–1176.Google Scholar
  27. 27.
    Elliott DS, Segura JW, Lightner D, et al. Is nephroureterectomy necessary in all cases of upper tract transitional cell carcinoma? Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney. Urology 2001; 58: 174–178.PubMedCrossRefGoogle Scholar
  28. 28.
    Matsuoka K, Lida S, Tomiyasu K, Inoue M, Noda S. Transurethral endoscopic treatment of upper urinary tract tumors using a holmium:YAG laser. Lasers Surg Med 2003; 32(5): 336–340.PubMedCrossRefGoogle Scholar
  29. 29.
    Suh RS, Faerber GJ, Wolf JS Jr. Predictive factors for applicability and success with endoscopic treatment of upper tract urothelial carcinoma. J Urol 2003; 170(6 Pt 1): 2209–2216.PubMedCrossRefGoogle Scholar
  30. 30.
    Tawfiek, ER, Bagley DH. Upper tract transitional cell carcinoma. Urology 1997; 50(3): 321–329.PubMedCrossRefGoogle Scholar
  31. 31.
    Chen GL, El-Gabry EA, Bagley DH. Surveillance of upper urinary tract transitional cell carcinoma: the role of ureteroscopy, retrograde pyelography, cytology and urinalysis. J Urol 2000; 165: 1901–1904.Google Scholar
  32. 32.
    Lee D, Trabulsi E, McGinnis D, Strup S, Gomella LG, Bagley DH. Totally endoscopic management of upper tract transitional cell carcinoma. J Endourol 2002; 16(1): 37–41.PubMedCrossRefGoogle Scholar
  33. 33.
    Sharpe JR, Duffy G, Chin JL. Intrarenal bacillus Calmette-Guerin therapy for upper urinary tract carcinoma in situ. J Urol 1993; 149: 457–460.PubMedGoogle Scholar
  34. 34.
    Eastham JA, Huffman JL. Technique of mitomycin C instillation in the treatment of upper urinary tract urothelial tumors. J Urol 1993; 150: 324–325.PubMedGoogle Scholar
  35. 35.
    Patel A, Fuchs GJ. New techniques for the administration of topical adjuvant therapy after endoscopic ablation of upper urinary tract transitional cell carcinoma. J Urol 1998; 159: 71–75.PubMedCrossRefGoogle Scholar
  36. 36.
    Keeley FX, Bibbo M, Bagley DH. Adjuvant mitomycin C following endoscopic treatment of upper tract transitional cell carcinoma. J Urol 1997; 158: 2074–2077.PubMedCrossRefGoogle Scholar
  37. 37.
    Chen GL, Bagley DH. Ureteroscopic surgery for upper tract transitional cell carcinoma: Complications and management. J Endourol 2001; 15: 399–404.PubMedCrossRefGoogle Scholar
  38. 38.
    Chow GK, Patterson RF, Blute ML, Segura JW. Ureteroscopy: effect of technology and technique on clinical practice. J Urol 2003; 170: 99–102.PubMedCrossRefGoogle Scholar
  39. 39.
    Tomera KM, Leary FJ, Zincke H. Pyeloscopy in urothelial tumors. J Urol 1982; 127: 1088–1089.PubMedGoogle Scholar
  40. 40.
    Lim DJ, Shattuck MC, Cook WA. Pyelovenous lymphatic migration of transitional cell carcinoma following flexible ureteroscopy. J Urol 1993; 149: 109.PubMedGoogle Scholar
  41. 41.
    Kulp DA, Bagley DH. Does flexible ureteropyeloscopy promote local recurrence of transitional cell carcinoma? J Endourol 1994; 8: 111–113.PubMedCrossRefGoogle Scholar
  42. 42.
    Hendin BN, Streem SB, Levin HS, et al. Impact of diagnostic ureteroscopy on long-term survivalin patients with upper tract transitional cell carcinoma. J Urol 1999; 161: 783–785.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc., Totowa, NJ 2006

Authors and Affiliations

  • Demetrius H. Bagley
    • 1
  1. 1.Departments of Urology and Radiology, Jefferson Medical CollegeThomas Jefferson UniversityPhiladelphia

Personalised recommendations