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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

The role of diagnostic ureteroscopy in the era of computed tomography urography

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Shay Golan, Andrei Nadu, David Lifshitz
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SG has made substantial contributions to conception and design, acquisition of data and data analysis. He has drafted the manuscript and approved the submitted version. AN has made substantial contributions to study design and manuscript revising. He approved the submitted version. DL has made substantial contributions to conception and design, data analysis and interpretation. He has been involved in drafting and revising the manuscript and approved the submitted version. All authors read and approved the final manuscript.

Abstract

Background

To examine the contemporary role of ureteroscopy in the diagnosis of upper urinary tract urothelial carcinoma.

Methods

We retrospectively evaluated 116 diagnostic ureteroscopies, performed in our institution to rule out primary UTUC. Demographics, cytological findings and interpretation of preoperative imaging were obtained. Ureteroscopic diagnosis and histological results were recorded and the predictive values of diagnostic studies were determined. Follow-up data was reviewed to evaluate the oncological outcomes in patients treated endoscopically.

Results

The pre-ureteroscopic evaluation included CTU in 91 (78 %) patients. Positive and Negative predictive values of CTU were 76 and 80 %, respectively. Typical filling defect on CTU was demonstrated in 38 of 89 patients. UTUC has been ruled out in 9 patients (24 %) with suspicious filling defect on CTU. Endoscopic approach was implemented in 7 patients (18 %). During a median follow up period of 17 months (IQR, 9–25) none of the followed patients experienced disease progression.

Conclusions

Nephroureterectomy was spared from 42 % of patients who underwent diagnostic ureteroscopy for suspected UTUC, demonstrated on CTU. In about half of those patients tumor has been ruled out and the others were managed endoscopically. Therefore, diagnostic ureteroscopy is advised as a crucial step in confirming UTUC and treatment planning.
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