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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

103
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
103
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

850
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
850
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

378
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
378
Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

519
The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
519
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

72
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
72

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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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Surgery for Bladder and Upper Tract Urothelial Cancer.

Vivek Venkatramani1, Dipen Jaysukhlal Parekh2

  • 1Nanavati Super-Specialty Hospital, S.V Road, Vile Parle West, Mumbai 400056, India; Department of Urology, University of Miami Miller School of Medicine.

Hematology/Oncology Clinics of North America
|May 7, 2021
PubMed
Summary

Surgery is key for diagnosing and treating urothelial carcinoma. Minimally invasive techniques and enhanced recovery are crucial for improving outcomes in bladder and upper tract cancer management.

Keywords:
Bladder cancerNephroureterectomyRadical cystectomyRobotic surgerySurgical managementTURBTUpper tract urothelial cancer

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Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Surgery is fundamental for the diagnosis and treatment of both bladder and upper tract urothelial carcinoma.
  • Transurethral resection of bladder tumors is a primary step in managing bladder cancer.
  • Radical cystectomy offers favorable oncologic outcomes for invasive bladder cancer but is associated with significant morbidity.

Purpose of the Study:

  • To highlight the essential role of surgical interventions in urothelial carcinoma.
  • To emphasize the need for integrating advancements like minimally invasive surgery and enhanced recovery protocols.
  • To outline diagnostic and treatment strategies for upper tract urothelial carcinoma based on risk stratification.

Main Methods:

  • Review of current surgical practices for bladder and upper tract urothelial carcinoma.
  • Discussion of diagnostic modalities including ureteroscopy, cytology, and imaging.
  • Evaluation of treatment approaches ranging from endoscopic resection to radical surgery.

Main Results:

  • Transurethral resection is the foundation for managing bladder tumors.
  • Radical cystectomy yields good oncologic results for invasive disease.
  • Minimally invasive surgery and early recovery protocols should be integrated into standard care.
  • Diagnostic ureteroscopy is vital for equivocal upper tract carcinoma cases.
  • Conservative endoscopic surgery is effective for low-risk upper tract cancers.
  • Radical nephroureterectomy is indicated for high-risk upper tract disease.

Conclusions:

  • Surgical management is central to urothelial carcinoma care.
  • Advancements in surgical techniques and recovery are essential for optimizing patient outcomes.
  • Risk-stratified surgical approaches are necessary for both bladder and upper tract urothelial carcinoma.