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PNL: Indications and Guidelines: Stenosis and Tumours

  • Marianne BrehmerEmail author
Chapter

Abstract

A stenosis in the upper urinary tract (UUT) can be of non-malignant or malignant origin.

In stenosis in the UUT, factors of significance for the choice of the treatment modality and for its results are location and length of the stricture, and renal function. Also the origin of the stricture, malignant or non-malignant, should be taken into consideration. Therefore, these factors should be adequately investigated prior to treatment.

Symptoms and/or findings suspicious for transitional cell carcinoma (TCC) in the UUT are strong indications for endoscopic examination. In case of TCC, for patients with solitary kidney or poor renal function the choice of endoscopic organ-sparing treatment or of radical nephroureterectomy will have important impact on the quality of life.

Keywords

Transitional Cell Carcinoma Urinary Diversion Solitary Kidney Macroscopic Haematuria Retrograde Approach 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Stilling NM, Jung H, Nørby B et al (2009) Retrograde ureteroscopic holmium laser endopyelotomy in a selected population of patients with ureteropelvic junction obstruction. Scand J Urol Nephrol 43:68–72PubMedCrossRefGoogle Scholar
  2. 2.
    Acher PL, Nair R, Abburaju JS et al (2009) Ureteroscopic holmium laser endopyelotomy for ureteropelvic junction stenosis after pyeloplasty. J Endourol 23:899–902PubMedCrossRefGoogle Scholar
  3. 3.
    Ponsky LE, Streem SB (2006) Retrograde endopyelotomy: a comparative study of hot-wire balloon and ureteroscopic laser. J Endourol 20:823–826PubMedCrossRefGoogle Scholar
  4. 4.
    El-Nahas AR, Shoma AM, Eraky I et al (2006) Percutaneous endopyelotomy for secondary ureteropelvic junction obstruction: prognostic factors affecting late recurrence. Scand J Urol Nephrol 40:385–390PubMedCrossRefGoogle Scholar
  5. 5.
    Conlin MJ, Bagley DH (1998) Ureteroscopic endopyelotomy at a single setting. J Urol 159:727–731PubMedCrossRefGoogle Scholar
  6. 6.
    Minervini A, Davenport K, Keeley FX, Timoney AG (2006) Antegrade versus retrograde endopyelotomy for pelvi-ureteric junction (PUJ) obstruction. Eur Urol 49:536–542, discussion 542–543PubMedCrossRefGoogle Scholar
  7. 7.
    Braga LH, Lorenzo AJ, Skeldon S et al (2007) Failed pyeloplasty in children: comparative analysis of retrograde endopyelotomy versus redo pyeloplasty. J Urol 178:2571–2575, discussion 2575PubMedCrossRefGoogle Scholar
  8. 8.
    Lin CM, Tsai TH, Lin TC et al (2009) Holmium: Yttrium-Aluminum-Garnet laser endoureterotomy for benign ureteral strictures: a single-centre experience. Acta Chir Belg 109: 746–750PubMedGoogle Scholar
  9. 9.
    Hatsuse K, Ono Y, Kinukawa T et al (2002) Long-term results of endopyeloureterotomy using the transpelvic extraureteral approach. Urology 60:233–237, discussion 237–238PubMedCrossRefGoogle Scholar
  10. 10.
    Biyani CS, Cornford PA, Powell CS (2000) Ureteroscopic endopyelotomy with the holmium: YAG laser. Mid-Term results. Eur Urol 38:139–143PubMedCrossRefGoogle Scholar
  11. 11.
    Renner C, Frede T, Seemann O, Rassweiler J (1998) Laser endopyelotomy: minimally invasive therapy of ureteropelvic junction stenosis. J Endourol 12:537–544PubMedCrossRefGoogle Scholar
  12. 12.
    Rassweiler JJ, Subotic S, Feist-Schwenk M et al (2007) Minimally invasive treatment of ureteropelvic junction obstruction: long-Term experience with an algorithm for laser endopyelotomy and laparoscopic retroperitoneal pyeloplasty. J Urol 177:1000–1005PubMedCrossRefGoogle Scholar
  13. 13.
    Babjuk M, Oosterlinck W, Sylvester R et al (2011) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2011 update. Eur Urol 59:997–1008PubMedCrossRefGoogle Scholar
  14. 14.
    Munoz JJ, Ellison LM (2000) Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol 164:1523–1525PubMedCrossRefGoogle Scholar
  15. 15.
    Kirkali Z, Tuzel E (2003) Transitional cell carcinoma of the ureter and renal pelvis. Crit Rev Oncol Hematol 47:155–169PubMedCrossRefGoogle Scholar
  16. 16.
    Hisataki T, Miyao N, Masumori N et al (2000) Risk factors for the development of bladder cancer after upper tract urothelial cancer. Urology 55:663–667PubMedCrossRefGoogle Scholar
  17. 17.
    Azémar MD, Comperat E, Richard F et al (2011) Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: frequency, risk factors, and surveillance. Urol Oncol 29:130–136PubMedCrossRefGoogle Scholar
  18. 18.
    Hurle R, Losa A, Manzetti A, Lembo A (1999) Upper urinary tract tumors developing after treatment of superficial bladder cancer: 7-year follow-up of 591 consecutive patients. Urology 53:1144–1148PubMedCrossRefGoogle Scholar
  19. 19.
    Millán-Rodríguez F, Chéchile-Toniolo G, Salvador-Bayarri J et al (2000) Upper urinary tract tumors after primary superficial bladder tumors: prognostic factors and risk groups. J Urol 164:1183–1187PubMedCrossRefGoogle Scholar
  20. 20.
    Novara G, De Marco V, Dalpiaz O et al (2009) Independent predictors of contralateral metachronous upper urinary tract transitional cell carcinoma after nephroureterectomy: multi-institutional dataset from three european centers. Int J Urol 16:187–191PubMedCrossRefGoogle Scholar
  21. 21.
    Holmäng S, Johansson SL (2006) Bilateral metachronous ureteral and renal pelvic carcinomas: incidence, clinical presentation, histopathology, treatment and outcome. J Urol 175:69–72, discussion 72–73PubMedCrossRefGoogle Scholar
  22. 22.
    Colin P, Koenig P, Ouzzane A et al (2009) Environmental factors involved in carcinogenesis of urothelial cell carcinomas of the upper urinary tract. BJU Int 104:1436–1440PubMedCrossRefGoogle Scholar
  23. 23.
    Keeley FX, Bibbo M, Bagley DH (1997) Ureteroscopic treatment and surveillance of upper urinary tract transitional cell carcinoma. J Urol 157:1560–1565PubMedCrossRefGoogle Scholar
  24. 24.
    Browne RF, Meehan CP, Colville J et al (2005) Transitional cell carcinoma of the upper urinary tract: spectrum of imaging findings. Radiographics 25:1609–1627PubMedCrossRefGoogle Scholar
  25. 25.
    Dillman JR, Caoili EM, Cohan RH et al (2008) Detection of upper tract urothelial neoplasms: sensitivity of axial, coronal reformatted, and curved-planar reformatted image-types utilizing 16-row multi-detector CT urography. Abdom Imaging 33:707–716PubMedCrossRefGoogle Scholar
  26. 26.
    Wang J, Wang H, Tang G et al (2009) Transitional cell carcinoma of upper urinary tract vs. benign lesions: distinctive MSCT features. Abdom Imaging 34:94–106PubMedCrossRefGoogle Scholar
  27. 27.
    Williams SK, Denton KJ, Minervini A et al (2008) Correlation of upper-tract cytology, retrograde pyelography, ureteroscopic appearance, and ureteroscopic biopsy with histologic examination of upper-tract transitional cell carcinoma. J Endourol 22:71–76PubMedCrossRefGoogle Scholar
  28. 28.
    Messer J, Shariat SF, Brien JC et al (2011) Urinary cytology has a poor performance for predicting invasive or high-grade upper-tract urothelial carcinoma. BJU Int 108:701–705PubMedGoogle Scholar

Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  1. 1.Department of Urology, Institution of Oncology and Pathology, Karolinska InstitutetAarhus University HospitalAarhus NDenmark

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