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Related Concept Videos

Imaging Studies II: Ultrasonography01:24

Imaging Studies II: Ultrasonography

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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Nursing Assessment of the Genitourinary System II: Inspection and Palpation01:26

Nursing Assessment of the Genitourinary System II: Inspection and Palpation

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The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
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Imaging Studies I: Kidney, Ureter, and Bladder Studies01:28

Imaging Studies I: Kidney, Ureter, and Bladder Studies

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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Imaging Studies IV: Magnetic Resonance Imaging01:27

Imaging Studies IV: Magnetic Resonance Imaging

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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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Imaging Studies III: Computed Tomography01:27

Imaging Studies III: Computed Tomography

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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
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Active Surveillance for Small Renal Masses.

Shagnik Ray1, Joseph G Cheaib1, Phillip M Pierorazio1

  • 1Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine Baltimore, MD.

Reviews in Urology
|June 12, 2020
PubMed
Summary

Active surveillance (AS) offers a safe management strategy for small renal masses (SRM) with excellent survival rates. This approach helps avoid overtreatment, especially in elderly or comorbid patients, promoting individualized care.

Keywords:
Active surveillanceChest imagingRenal cell carcinomaRenal mass biopsySmall renal mass

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Area of Science:

  • Urology
  • Oncology
  • Nephrology

Background:

  • Active surveillance (AS) is a viable option for small renal masses (SRM) suspicious for clinical T1a renal cell carcinoma.
  • Robotic surgery expansion may lead to overtreatment of SRMs, particularly in elderly and comorbid patients.

Purpose of the Study:

  • To review the rationale and evidence supporting AS for SRMs.
  • To provide guidance on patient selection and follow-up protocols for AS.
  • To emphasize AS as a method to avoid overtreatment and personalize patient care.

Main Methods:

  • Review of literature on AS for SRMs.
  • Focus on data from the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) Registry.
  • Analysis of survival outcomes and patient selection criteria.

Main Results:

  • AS demonstrates excellent metastasis-free and cancer-specific survival for SRMs.
  • Over-treatment is a concern due to increased adoption of surgical interventions.
  • Evidence supports AS for appropriate patient cohorts.

Conclusions:

  • AS is a safe and reasonable management strategy for select patients with SRMs.
  • Improved understanding of AS data can increase physician and patient confidence in this approach.
  • AS facilitates individualized care and helps prevent overtreatment of SRMs.