Ureteroscopic management of chronic unilateral hematuria: a single-center experience over 22 years

To analyze the short and long term safety and efficacy of ureteroscopic evaluation and management of chronic unilateral hematuria. We retrospectively reviewed patients with chronic unilateral hematuria from 1987 to 2008. The distal to middle ureter was evaluated with a semi-rigid ureteroscope withou...

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Bibliographic Details
Published in:PloS one 2012-06, Vol.7 (6), p.e36729-e36729
Main Authors: Araki, Motoo, Uehara, Shinya, Sasaki, Katsumi, Monden, Koichi, Tsugawa, Masaya, Watanabe, Toyohiko, Monga, Manoji, Nasu, Yasutomo, Kumon, Hiromi
Format: Article
Language:English
Subjects:
Abnormalities
Adolescent
Adult
Aged
Aged, 80 and over
Analysis
Bleeding
Calculi
Calculus
Care and treatment
Cellular biology
Chronic Disease
Dentistry
Electrocoagulation - instrumentation
Electrocoagulation - methods
Endoscopy
Evaluation
Female
Follow-Up Studies
Hemangioma
Hematology
Hematuria
Hematuria - pathology
Hematuria - surgery
Humans
Incidence
Instrumentation
Iodine
Kidneys
Lesions
Male
Medical diagnosis
Medical imaging
Medicine
Middle Aged
Patients
Pelvis
Pharmaceutical sciences
Retrospective Studies
Surgery
University graduates
Ureter
Ureteroscopy - instrumentation
Ureteroscopy - methods
Urine
Urogenital system
Urology
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Summary:To analyze the short and long term safety and efficacy of ureteroscopic evaluation and management of chronic unilateral hematuria. We retrospectively reviewed patients with chronic unilateral hematuria from 1987 to 2008. The distal to middle ureter was evaluated with a semi-rigid ureteroscope without a guidewire. Subsequently, the flexible ureteroscope was advanced into the upper ureter to the renal pelvis using a low-pressure automated irrigant system (Uromat™). Lesions identified ureteroscopically were treated with diathermy fulguration. One hundred and four (56 male, 48 female) patients were identified, with a median age of 37 (14-80) years and median follow-up of 139 (34-277) months. The median preoperative duration of gross hematuria was 5 (1-144) months. Endoscopic findings included 61 (56%) minute venous rupture (MVR; a venous bleeding without clear abnormalities), 21 (20%) hemangioma (vascular tumor-like structure), 3 (3%) varix (tortuous vein), 1 (1%) calculus and 18 (17%) no lesions. The incidence of "no lesions" was less in the recent 12 years (9%) than the first 10 years (27%), while the incidence of MVR increased from 40 to 66% (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0036729