Diagnosis of urothelial tumor by ureterorenoscopy

In the past, radiologically detected filling defects in the upper urinary tract were correctly interpretable only by means of cytological techniques. The introduction of ureterorenoscopy has provided a reliable method for the detection of tumors in the ureter and renal pelvis. In contrast to transurethral ureterolithotripsy, diagnostic ureterorenoscopy entails few complications. It thus fills a diagnostic gap and facilitates therapeutic planning. A report is presented on 15 patients with obscure hematuria, or unclear filling defects in the upper urinary tract. In 10 patients, the unequivocal diagnosis of urothelial carcinoma was endoscopically and bioptically established by ureterorenoscopy. Small nonradiopaque concrements were found in 3 cases. The origin of hemorrhage could not be determined in 2 patients.