The endoscopic approach to the distal ureter in nephroureterectomy for upper urinary tract tumor
Publication Type
Conference Paper

Objectives: To evaluate the efficacy and safety of endoscopic resection of lower ureter in upper urinary tract tumor cases.

Materials and Methods: Seven patients (4 male, 3 female) with mean age of 62.58 (36-74), who were diagnosed to have upper transitional cell tumor were enrolled. In lithotomy position the endoscopic transurethral resection of lower ureter and bladder cuff was carried out followed by the insertion of Foley catheter, then moved to flank position and one-step nephroureterectomy was done. Urethral catheter was removed after one week postoperatively. The histologic examination revealed organ confined tumor in five patients and non organ confined in two patients: one had positive lymph node and another had bladder tumor in the resected material from the bladder. The complications and recurrence rates were evaluated. The mean follow-up period was 11.58 months(range:3-24).

Results: There were no intra-operative complications related to endoscopic resection. One patient had gross hematuria after resection, and it was managed by minimal traction of the urethral catheter for few hours. Two patients who had positive lymph node and positive malignancy at the resected material of the bladder  had disease local recurrence postoperatively at 24 months and 12 months respectively. The remaining patients are free of malignancy.

Conclusions: Endoscopic resection of lower ureter in selected patients with upper urinary tract tumors represent feasible option for one-step nephrouretoectomy. It can lead to lower morbidity, shorter operation time, and higher patient's satisfaction. Large number patients with long follow-up periods are needed before final decision could be drawn.

Conference Title
turkish internartional urology congress
Conference Country
Conference Date
Jan. 1, 2008 - Jan. 1, 2008
Conference Sponsor
turkish internartional urology congress