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