Practical Implementation of Ureteroscopy in Upper Tract Urothelial Carcinoma

, Seung Chol Park

Review Article

The Korean Journal of Urological Oncology 2013;11(2):71-76.
Published online August 30, 2013.

상부요로상피암에서 요관경의 실제

박승철

원광대학교 의과대학 비뇨기과학교실, 원광의과학연구소

Practical Implementation of Ureteroscopy in Upper Tract Urothelial Carcinoma

Seung Chol Park

Department of Urology, Wonkwang University School of Medicine and Hospital, Institute of Wonkwang Medical Science, Iksan, Korea

Correspondence: Seung Chol Park

Abstract

Upper urinary tract urothelial carcinomas involving renal pelvis or ureter are relatively uncommon, accounting for 5-7% of all renal tumors and about 5% of all urothelial tumors. The most common symptom is gross or microscopic hematuria. Flank pain and lumbar mass are common symptoms of upper tract urothelial carcinoma. Diagnosis of upper urothelial carcinoma based on imaging study included computed tomography urography, cystoscopy with urine cytology, and diagnostic ureteroscopy with biopsy. The traditional pitfalls of upper tract urothelial carcinoma diagnosis, namely poor visualization and difficulty in obtaining representative histological samples, are being circumvented by the introduction of modern digital flexible ureteroscope that can be combined with phothodynamic diagnosis and narrow band image to improve tumor classification, deferring to conservative treatment. The accuracy of the diagnostic work-up of upper tract urothelial carcinoma is very important for decision-making of treatment. The development of technology can allow us more accurate biological information of upper tract urothelial carcinoma. (Korean J Urol Oncol 2013;11:71-76)

Key Words: Upper urinary tract, Urothelial carcinoma, Ureteroscopy