Renal brush biopsy: survey of indications, techniques and results

Urine cytology is inaccurate in the diagnosis of low grade tumors of the ureter and pelvis. In 1973 the retrograde brush biopsy technique was introduced in an effort to improve diagnostic capabilities. We herein review our experience with retrograde brushing of upper urinary tract radiolucent filling defects in 21 patients during a 6-year period. In addition, we have surveyed other urologists concerning their experience with this new technique. The data accrued from both sources, involving 68 procedures, were analyzed with respect to the results, technique and complications of this procedure. In lesions from which tissue was obtained we found an over-all diagnostic accuracy rate of 78 per cent. The major and minor complication rates were 7 and 34 per cent, respectively. Our results support the conclusion that this procedure is of value in the management of selected patients with problem radiolucent filling defects of the renal pelvis and ureter.