[Rigid ureteroscopy in the case of suspected tumor of the upper urinary tract: report of 63 cases].

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie

PubMedID: 11980009

Morel Journel N, Manel A, Chaffanges P, Champetier D, Devonec M, Perrin P. [Rigid ureteroscopy in the case of suspected tumor of the upper urinary tract: report of 63 cases]. Prog Urol. 2002;12(1):15-20.
OBJECTIVE
This retrospective study was designed to determine the place of rigid ureteroscopy in the diagnosis of upper urinary tract tumours.

MATERIAL AND METHODS
63 patients (45 males and 18 females) with a mean age of 60 years, were investigated by rigid ureteroscopy for suspected upper urinary tract tumour. The Wolf 8-9.8 F ureteroscope was used in the case of suspected upper urinary tract tumour in a context of ureteric obstruction on the IVU in 29 cases, haematuria in 23 cases, a defect on retrograde ureteropyelography in 5 cases, suspicious CT scan in 5 cases and positive cytology with normal cystoscopy in 2 cases.

RESULTS
The ureteroscope was able to be advanced as far as the suspicious zone in 89% of cases. The mean operating time was 48 minutes and the mean hospital stay was 3.2 days. Diagnostic rigid ureteroscopy has a Sensitivity of 58% (95% confidence interval CI95: +/- 28), a Specificity of 100%, a Positive Predictive Value of 100%, a Negative Predictive Value of 91% (+/- 7) and a low morbidity (3%).

CONCLUSION
Rigid ureteroscopy does not appear to be the examination of choice for the diagnosis of upper urinary tract tumours, as it cannot investigate the renal pelvis or calices and the ureteroscope cannot always be advanced to the suspicious zone. The flexible ureteroscope now appears to be a more reliable diagnostic tool.