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Related Experiment Videos

Ureteroscopic biopsy in the upper urinary tract

O M Abdel-Razzak1, H Ehya, A Cubler-Goodman

  • 1Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania.

Urology
|September 1, 1994
PubMed
Summary

For upper urinary tract lesions, forceps and baskets are optimal biopsy instruments for flexible ureteroscopy. These devices yield larger specimens, improving diagnostic accuracy compared to brushes or aspiration alone.

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Area of Science:

  • Urology
  • Pathology
  • Endourology

Background:

  • Ureteroscopic biopsy of upper urinary tract lesions is challenging due to small working channels.
  • Accurate tissue sampling is crucial for diagnosis and treatment planning.

Purpose of the Study:

  • To evaluate the efficacy of various instruments and techniques for ureteroscopic biopsy of upper urinary tract lesions.
  • To identify optimal methods for obtaining diagnostic specimens through small ureteroscope channels.

Main Methods:

  • Biopsies of upper urinary tract lesions were performed using flexible and semirigid ureteroscopes.
  • Instruments included cup biopsy forceps, baskets, graspers, snare, brush, and aspiration catheters.
  • Specimens underwent cytopathologic study, with diagnostic samples considered definitively positive or negative.

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Main Results:

  • Forceps and baskets provided definitive results in a higher proportion of samples compared to brushes or aspiration.
  • While aspiration/washings were less diagnostic overall, they identified some tumors missed by other methods.
  • Technical limitations like bleeding and instrument positioning impacted specimen adequacy.

Conclusions:

  • Obtaining the largest possible biopsy specimen is key for accurate diagnosis.
  • Tissue sampling devices like forceps and baskets are advantageous for larger specimen acquisition.
  • Cytopathologic techniques are vital for interpreting small specimens from ureteroscopic biopsies.