Ureteroscopy

During the kidney cancer diagnosis process, the care team may recommend that the patient gets a ureteroscopy as a way for doctors to see inside the kidneys and ureters.

What is a ureteroscopy?

A ureteroscopy uses a special endoscope with a light on it (called a ureteroscope) to look at the ureters (tubes that link the kidneys and bladder) and the kidneys. It may be used for kidney cancer detection and to find and examine tumors in the urinary tract.

The care team also may use a ureteroscopy for other reasons, such as to place small instruments through the ureteroscope to remove kidney stones or to help diagnose recurrent urinary tract infections.

How to prepare for a ureteroscopy

Below are a few steps patients may take ahead of a ureteroscopy, but be sure to ask the care team for their recommendations.

• Ask someone to drive home after the ureteroscopy.
• Inform the care team about any medications the patient takes, including over-the-counter supplements or herbs.
• Find out if there are any medications the patient should discontinue in advance, such as aspirin or blood thinners.
• Ask if it’s OK to eat or drink the day of the procedure.

What to expect during the ureteroscopy procedure

The patient may receive general anesthesia or sedation for a ureteroscopy, via an intravenous (IV) needle in his or her arm or hand vein. General anesthesia puts the patient to sleep, while sedation helps him or her relax.

Then the doctor places the tip of the ureteroscope into the urethra (the tube removing urine from the bladder) until it reaches a ureter. The ureteroscope has a light and camera on the end.

The doctor may choose to move the ureteroscope up to the kidney. With the help of small instruments used via the ureteroscope, it’s possible to perform a kidney biopsy or check or remove a tumor or growth. If the doctor takes a tissue sample during the procedure, a pathologist may then look at it for indications of cancer.

How long does a ureteroscopy take?

A ureteroscopy usually takes about one hour.

If the patient receives general anesthesia, he or she may have to wait a couple of hours before going home. A health professional may ask the patient to urinate before heading home. On occasion, the patient may have to stay overnight in the hospital after having a ureteroscopy.

Ureteroscopy recovery

After a ureteroscopy, the care team may ask the patient to:

• Use antibiotics for a day or two to help prevent infection.
• Use a pain reliever as needed.
• Drink a lot of water to help flush out the urinary tract.
• Apply a warm washcloth to the area where the urethra opens to ease any pain.
• Rest for a day or so (it may take a couple more days to feel fully recovered).

Ureteroscopy risks and benefits

The benefit of a ureteroscopy for cancer detection is it helps the care team find any tumors and recommend treatment for them as needed.

Side effects of ureteroscopy

General side effects of a ureteroscopy include:

• Blood in the urine for a few days
• Need to urinate more often
• Pain when urinating
• Pain in the bladder (ask the doctor if it’s OK to use a warm bath or a heating pad to help with this pain)

Alert the care team if any of these symptoms occur:

• Abnormal bleeding
• Abnormal pain
• Urinary tract infection
• Inability to urinate because of tissue swelling

Seek urgent medical attention for any of the following more serious risks:

• Fever
• Acute pain
• Bright red urine
• Inability to urinate despite feeling of full bladder
• Painful urination that lasts for more than two days

Other risks from a ureteroscopy include scarring or injury to the ureters.

Ureteroscopy results

Discuss the results from a ureteroscopy with the care team. Make sure to ask any questions during the visit.

The care team may want to have other tests performed to diagnose cancer of the ureter or kidneys. These tests may include:

• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Ultrasound
• Urine cytology

Additional tests may help the care team determine a kidney cancer stage. Staging helps describe how far the cancer has spread. This may involve the use of numbers—such as stage 0 or 1 indicating the earliest stage and stage 4 kidney cancer as the most advanced—or the use of the terms localized, regional, metastatic or recurrent.

A combination of test results may help the care team decide how to approach cancer treatment. Surgery, regional chemotherapy and regional biologic therapy are among the kidney cancer treatment options. Cancer that is limited to the kidney or ureter may be removed using surgery only.

For kidney or ureter cancer that has spread to other parts of the body, connect with the care team about possible clinical trials that may be a good fit.