Endoscopic Management of Upper Urinary Tract Urothelial Carcinoma

Incidental Diagnosis of Renal Pelvic Tumor in Patients Who Underwent Percutaneous Nephrolithotomy: A Report of 6 Cases and Review of the Literature

OBJECTIVES

To report the clinical characteristics of patients who were incidentally diagnosed as renal pelvic tumor during or after percutaneous nephrolithotomy (PNL).

METHODS

The profiles of about 8,000 patients who underwent PNL in our center from 2011 to 2021 were retrospectively reviewed, 6 patients were diagnosed with renal pelvic tumor during or after PNL. Clinical data of these six patients were collected and summarized.

RESULTS

Four males and two females with the average age of 59 years were researched. Chief complaints included loin pain, gross hematuria, and wound infection after PNL. Two patients had a definite long history of stones. Urinary tract infection occurred in 5 patients and all six patients had gross hematuria or microscopic hematuria. CT images revealed severe hydronephrosis in 4 patients and moderate hydronephrosis in 2 patients. Both staghorn and multiple stones were separately seen in 3 patients. Five patients were diagnosed with renal pelvic urothelial carcinoma via biopsy during PNL. One patient was diagnosed as renal pelvic tumor with extensive invasion by postoperative CT scan and received palliative treatment. Of two patients underwent radical surgery, one patient obtained long survival, one patient received endoscopic tumor resection and also obtained long survival. Two patients underwent renal artery embolization, one patient was still alive after 22 months, the other patient showed tumor growth in 3 weeks.

CONCLUSIONS

The possibility of renal pelvic tumor should be considered in stone patients with several risk factors including elder age, long history of stones, complicated stones, hydronephrosis especially pyonephrosis, obvious hematuria etc.

Role of lasers in urology

Laser technology has long been a standard treatment for many diseases. In particular, laser treatment is considered the standard of care in various urological diseases. While originally primarily restricted to stone treatment, lasers have since evolved to play an important role even in the treatment of malignant diseases. In this review, we take a closer look at the history of lasers in urology and some implications for treatments today.