Laser treatment of ureteral tumors

Ureteroscopic laser coagulation was performed in 20 patients. In 4 of these patients endoscopic treatment was judged to be incomplete and biopsy demonstrated a muscle invasive tumor in 3 and a poorly differentiated tumor in 1. Therefore, segmental resection or nephroureterectomy followed. In the other 16 patients laser treatment alone (8) or in conjunction with electroresection (8) eradicated the tumor successfully. All of these were stage Ta or T1 and grade 1 or 2 tumors. Three recurrences (after 12, 24 and 49 months) were detected within a medium observation period of 13.8 months and could be eradicated easily with the laser, since these tumors were small. A ureteral stricture developed at the treatment site once in the "laser only" group and 3 times in the group with laser treatment and electroresection. Endoscopic laser coagulation seems to be a promising treatment modality for selected small ureteral tumors. Electroresection has a high risk for development of a ureteral stricture. Regular retrograde ureteropyelography is mandatory for follow-up.