Adenocarcinoma ; diagnosis ; surgery ; Aged ; Humans ; Male ; Treatment Outcome ; Ureteral Neoplasms ; diagnosis ; surgery

We report a case of primary fibroepithelial polyp of the right midureter. The patient was a 41-year-old-woman, complaining of right flank pain. An excretory urogram revealed right hydronephrosis and a filling defect of the the right midureter. The filling defect was produced by a large fibroepithelial polyp that was diagnosed and removed by ureteroscopy without open surgery. Large fibroepithelial ureteral polyps are relatively rare and ureteroscopy is the gold standard of diagnosis for ureteral filling defect.
Adult ; Case Report ; *Endoscopy ; Female ; Human ; Polyps/pathology/*surgery ; Ureter/pathology/*surgery ; Ureteral Neoplasms/pathology/*surgery ; Ureteroscopy

OBJECTIVETo study the effect of 70 degrees recumbent position transperitoneal laparoscopy for treatment of upper urinary tract transitional cell carcinoma (TCC).

METHODSFrom May 2004 to January 2007, 70 degrees recumbent position transperitoneal laparoscopy combined with urethral resectoscope was used to treat 31 cases of upper urinary tract transitional cell carcinoma. At the same time titanium clip to occlude the two extremities of ureter tumor was used, extracting specimen by oblique incision of lower quadrant.

RESULTSAll operations were finished successfully, no one was turned to open surgery; mean operation time was 140 min, mean blood loss 80 ml, mean hospital stay time 8 d, without complications of urine leakage and intestinal fistula and so on.

CONCLUSIONS70 degrees recumbent position transperitoneal laparoscopy for resection of whole kidney and ureter is worth of general clinical application because it could provide large space for operation, simplify the treatment of renal pedicle vessels, decrease operation risk, reduce operation trauma and offer early recovery. But its effect on tumor spread and recurrence will still need long term follow-up.

Adult ; Aged ; Carcinoma, Transitional Cell ; surgery ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Posture ; Treatment Outcome ; Ureteral Neoplasms ; surgery ; Urinary Bladder Neoplasms ; surgery

OBJECTIVE: To investigate the correlation between drinking habits and pathological characteristics of patients with upper tract urothelial carcinoma (UTUC). METHODS: A preoperative questionnaire survey was conducted to understand the drinking habits of UTUC patients who were admitted to the Department of Urology, Peking University First Hospital for radical nephroureterectomy within one year from August 2020 to July 2021, and statistical analysis was performed in combination with their postoperative pathological characteristics. The statistical procedure was performed using SPSS 22.0 software, and firstly, the preliminary analysis was performed one by one using the columnar χ² test on the pathological characteristics of UTUC tumors as the dependent variable and the factors related to patients' general information, past history and drinking habits as the independent variables, and the independent variables that met P < 0.2 between the case and control groups for each dependent variable were specified for screening. The screened variables were included in the binary Logistic regression analysis. A difference of P < 0.05 was used to indicate a statistically significant difference. RESULTS: A total of 239 patients, 134 males and 105 females, with a mean age of (68.1±9.98)years and a median disease duration of 4.8 months, were included in this study. Multifactorial Logistic regression results suggested that after adjusting for the effects of other variables, UTUC patients who had the habit of drinking at least once every hour during the daytime had a significantly increased risk of high grade (G3) tumors(OR=1.941, 95%CI: 0.352-1.029, P < 0.01); these patients also had a significantly decreased risk of multifocal UTUC tumors (OR=0.344, 95% CI: 1.18-5.582, P=0.004). The patients who had the habit of drinking over 100 mL water each time had a significantly decreased risk of mutifocal UTUC incidence (OR=0.477, 95%CI: 0.225-1.012, P=0.046). Patients who pay attention to daily water intakes had a significantly increased risk of renipelvic carcinoma (OR=2.530, 95%CI: 1.434-4.463, P=0.001) and a significantly decreased risk of ureteral carcinoma (OR=0.314, 95%CI: 0.172-0.573, P < 0.01). Other variables included in the regression model did not differ significantly in their effects on the occurrence of tumor pathological characteristics. CONCLUSION Having the awareness of drinking water every 1 h during the day, drinking over 100 mL water each time, having the awareness of daily drinking habits correlated significantly with pathological characteristics of UTUC such as the presence of G3 tumor, multifocal tumors and location of the tumor. This conclusion still needs to be verified by subsequent trials with higher levels of evidence.
Carcinoma, Transitional Cell/surgery* ; Female ; Habits ; Humans ; Male ; Neoplasm Recurrence, Local/epidemiology* ; Retrospective Studies ; Ureteral Neoplasms/surgery* ; Urinary Bladder Neoplasms/surgery* ; Water

Various laparoscopic nephroureterectomy techniques for urothelial carcinoma of the upper urinary tract have been developed to minimize postoperative discomfort and the necessity for a lengthy convalescence. We performed hand-assisted retroperitoneoscopic nephroureterectomy without hand-assisted device in 3 male patients with urothelial carcinoma of the distal ureter. Average operative time and estimated blood loss were 251 min (range 235 to 280) and 250 mL (range 200 to 300), respectively. Complication did not occur and conversion to open surgery was not necessary in all cases. Postoperative analgesic requirements were moderate and the time to regular diet intake averaged 3 days (range 2 to 4). None of the patients had a positive margin on the final pathologic specimen. At the average follow-up of 8.1 months, no regional recurrence, port-site metastasis, bladder recurrence, or distant metastasis were noted in any patient. We described our initial experience with the described technique, which obviates the need for midprocedural patient repositioning.
Aged ; Humans ; Laparoscopes ; Laparoscopy/*methods ; Male ; Middle Aged ; Nephrectomy/instrumentation/*methods ; Retroperitoneal Space/pathology/*surgery ; Treatment Outcome ; Ureter/pathology/*surgery ; Ureteral Neoplasms/pathology/*surgery

A 70-yr-old man presented with painless gross hematuria. He underwent right nephrectomy for benign disease 9 yr ago. Computed tomography and cystoscopy showed a mass in the distal region of the right ureteral stump. He underwent right ureterectomy and bladder cuff resection. Pathological examination showed T1 and WHO grade 2 transitional cell carcinoma. At 6 months postoperatively, the patient is alive without any evidence of recurrence.
Aged ; Carcinoma, Transitional Cell/*diagnosis/pathology/surgery ; Cystoscopy ; Hematuria/urine ; Humans ; Kidney Diseases/*surgery ; Male ; Nephrectomy ; Tomography, X-Ray Computed ; Ureteral Neoplasms/*diagnosis/pathology/surgery

Adenocarcinoma ; diagnosis ; secondary ; surgery ; Aged ; Biopsy ; Cystoscopy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Laparoscopy ; Male ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; surgery ; Radiography ; Transurethral Resection of Prostate ; methods ; Ureteral Neoplasms ; diagnosis ; secondary ; surgery ; Ureteroscopy ; Urethral Neoplasms ; diagnosis ; secondary ; surgery ; Urothelium ; pathology

OBJECTIVETo evaluate the prognostic factors of ureter transitional cell carcinoma (TCC).

METHODSBetween January 2001 and December 2005 133 TCC patients were treated. And the data was retrospectively analyzed.

RESULTSA mean age of the 133 patients was 68 years (range 43 - 87 years) at diagnosis. Altogether the non-invasive ureter TCC was found in 42 patients (31.6%) and the invasive ureter TCC in 91 patients (68.4%). Invasive ureter TCC growth was more common in distally located tumors (82.5%) compared to mid (62.5%) and proximal ureter (47.1%). Tumor stage, grade and location of the tumor were all correlated with disease specific survival in a univariate analysis. In a multivariate Cox analysis, tumor stage and grade were significantly associated with disease specific survival.

CONCLUSIONSMore invasive tumors are found in ureter than in bladder. Ureter cancer is more frequently found in the distal part. Distally located ureteral tumors are more likely invading into the muscular cell layers compared to proximally located tumors. Tumor stage and grade are still the more important prognostic factors for ureter TCC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis ; Ureteral Neoplasms ; pathology ; surgery

OBJECTIVETo compare the efficacy between total ureterectomy and partial ureterectomy in treatment of ureteral carcinoma.

METHODSThe clinical data and follow-up results of 102 patients with ureteral urothelial carcinoma from August 1996 to August 2011 were analyzed retrospectively. According to surgical procedures, the patients were divided into total ureterectomy group (61 cases) and partial ureterectomy group (41 cases). The subsequent bladder cancer incidence, ureteral carcinoma recurrence rate, distant metastasis rate and survival rate were compared between two groups. The prognostic factors of ureteral carcinoma were analyzed by multivariable Cox regression.

RESULTSNineteen patients (31.1%) suffered subsequent bladder cancer in total ureterectomy group, and 10 (24.4%) in partial ureterectomy group(χ² = 0.550, P = 0.458). Ten patients (16.4%) re-suffered contralateral ureteral carcinoma in total ureterectomy group, and 6 (14.6%) in partial ureterectomy group, 2 (4.9%) ipsilateral and 4 (9.7%) contralateral (χ² = 0.057, P = 0.811). Eight patients (13.1%) occurred distant metastasis in total ureterectomy group, and 3 (7.3%) in partial ureterectomy group (χ² = 0.360, P = 0.549). Twenty patients died of carcinoma in total ureterectomy group, and 18 in partial ureterectomy group. The median survival time was 78 months in total ureterectomy group, and 75 months in partial ureterectomy group. The 1-year, 3-year and 5-year survival rates in total ureterectomy group were 97.8%, 76.8% and 63.6%, and in partial ureterectomy group were 93.0%, 66.9% and 58.8%. The multivariable Cox regression analysis revealed that tumor stage (RR = 2.468, P = 0.009) and local lymph node status (RR = 3.081, P = 0.020) were independent prognostic factors of ureteral carcinoma. The 5-year survival rate of Ta-2 stage tumor was 73.4%, and of T3-4 stage was 42.8%.

CONCLUSIONSTumor stage and local lymph node status are key prognostic factors of ureteral carcinoma. The efficacy between total ureterectomy and partial ureterectomy in treating early stage of low ureteral carcinoma is similar. Partial ureterectomy can be used in selective patients.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Ureter ; surgery ; Ureteral Neoplasms ; surgery

Carcinoma, Renal Cell ; metabolism ; pathology ; surgery ; Carcinoma, Transitional Cell ; metabolism ; pathology ; surgery ; Carcinosarcoma ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Keratins ; metabolism ; Kidney Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Prostatic Neoplasms ; metabolism ; pathology ; surgery ; Retrospective Studies ; Survival Rate ; Ureteral Neoplasms ; metabolism ; pathology ; surgery ; Urinary Bladder Neoplasms ; metabolism ; pathology ; surgery ; Urologic Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism