1280 URETEROSCOPIC EVALUATION AND TREATMENT OF CHRONIC UNILATERAL HEMATURIA: ANALYSIS OF THE LATEST 20 CASES

Abstract

You have accessJournal of UrologyTechnology & Instruments: Ureteroscopy1 Apr 20101280 URETEROSCOPIC EVALUATION AND TREATMENT OF CHRONIC UNILATERAL HEMATURIA: ANALYSIS OF THE LATEST 20 CASES Soichi Mugiya, Masao Nagata, Yutaka Kurita, and Seiichiro Ozono Soichi MugiyaSoichi Mugiya More articles by this author , Masao NagataMasao Nagata More articles by this author , Yutaka KuritaYutaka Kurita More articles by this author , and Seiichiro OzonoSeiichiro Ozono More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.851AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Chronic unilateral hematuria is characterized by intermittent or continuous gross hematuria that cannot be diagnosed using standard radiology and hematology methods. We have evaluated patients with unilateral renal hematuria to determine the cause of bleeding and reported the usefulness of ureteroscopic treatment for this condition (J Urol 178: 517, 2007). Our experience and the technique have improved with time. We report our recent experience with patients who had chronic unilateral hematuria and were treated ureteroscopically. METHODS From March 2005 to June 2009, 20 patients were referred to our institution for the evaluation and treatment of chronic unilateral hematuria. Radiology and hematology tests failed to reveal the source of hematuria and showed normal findings. Preoperative urine cytology also showed no abnormalities, and subsequently all the patients were investigated ureteroscopically. In the case of a lesion being identified after complete inspection of the collecting systems, the bleeding site was treated ureteroscopically with a laser (holmium: YAG and/or neodymium: YAG) or electrocoagulation. RESULTS 20 patients who were evaluated for gross unilateral hematuria, including 9 males and 11 females 18 to 82 years old (mean age 41). Hematuria was on the left side in 14 patients. The entire ureter and intrarenal collecting systems were inspected in all patients. Discrete lesions were found ureteroscopically in 19 patients, including minute venous rupture in 15 and hemangioma on a renal papilla in 4. In the remaining one patient, since gross hematuria disappeared before the ureteroscopic procedure, the source of hematuria could not be detected by ureteroscopic evaluation. 19 patients with detected lesions were treated ureteroscopically with a laser or electrocoagulation since active bleeding spots were recognized during the ureteroscopic procedure. In all treated patients hematuria resolved with no recurrence during a median follow-up of 16 months (range 5 to 56). CONCLUSIONS A patient in whom the cause of hematuria is unknown should undergo ureteroscopic evaluation, and ureteroscopic treatment is an excellent method for chronic unilateral hematuria. Hamamatsu, Japan© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e496 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Soichi Mugiya More articles by this author Masao Nagata More articles by this author Yutaka Kurita More articles by this author Seiichiro Ozono More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...