LIMITATIONS OF URETEROSCOPY IN DIAGNOSIS OF INVASIVE UPPER TRACT UROTHELIAL CANCER

The efficacy of ureteroscopic evaluation of upper tract abnormalities was evaluated in 40 patients, Twenty-eight patients presented with a r adiologic filling defect, 9 with a filling defect and hematuria and 3 individuals exhibited hematuria alone. Cold cup biopsies revealed tran sitional cell carcinoma in 7 of 9 patients with papillary tumors and i n 2 of 3 with nonpapillary tumors. Four patients without ureteroscopic diagnosis of urothelial cancer were found to have invasive tumors on subsequent nephroureterectomy, Of 15 patients with upper tract urothel ial cancer, 12 were treated with total nephroureterectomy. Three indiv iduals with grade 1 neoplasms received conservative ureteroscopic abla tive therapy. Ureteroscopy is effective when combined with biopsy in t he diagnosis and treatment of papillary lesions, but exhibits a low se nsitivity in patients with invasive lesions.