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Surveillance of the Upper Tract After Conservative Treatment

  • Joel Hillelsohn
  • Majid Eshghi
Chapter

Abstract

Surveillance is essential following endoscopic treatment for upper tract urothelial carcinoma. However unlike lower tract disease, surveillance cannot be performed in an outpatient basis. It is therefore critical to have a multidisciplinary approach to ensure follow-up. Conservative treatment which involves multiple invasive procedures can be cumbersome, for the patient and constant physician–patient dialogue must be maintained. We will outline the optimal approach in explaining to a patient and their families, what surveillance entails. Our surveillance protocol involves flexible cystoscopy, CT or MR urogram, and upper endoscopy in first 3 months. This is followed by repeat ureteroscopy, cytologies, cystoscopies, and imaging in 3–6 month intervals.

Keywords

Surveillance upper tract Patient fatigue Upper tract recurrence Virtual ureteroscopy Mitomycin C Familial support Patient doctor therapeutic relationship 

Notes

Acknowledgements

Author acknowledges the contribution of Gerald Matthews, MD, Westchester Medical Health Network, New York Medical College, Valhalla, NY and thanks him for his helpful comments and feedback.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyWestchester Medical Health Network/New York Medical CollegeValhallaUSA

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