Bladder Chemoprophylaxis Following Ureterorenoscopy in Patients with Upper Tract Urothelial Carcinoma

Eur Urol Focus. 2022 Sep;8(5):1253-1255. doi: 10.1016/j.euf.2021.07.007. Epub 2021 Jul 31.

Abstract

Kidney-sparing procedures for upper tract urothelial carcinoma (UTUC) have evolved from imperative to elective indications for management of low-risk disease. Ureterorenoscopy is the most common procedure for the diagnosis, treatment, and surveillance of UTUC. A notable consideration following ureterorenoscopy is the higher risk of downstream bladder seeding. Here we review the importance of and scientific evidence for chemoprophylaxis after ureterorenoscopy. PATIENT SUMMARY: For patients with low-risk cancer of the upper urinary tract, a procedure called ureterorenoscopy (URS) involving insertion of a thin telescope through the ureter and into the kidney is increasingly used for biopsy. URS increases the risk of cancer seeding in the bladder. We review evidence on the benefit of prophylactic bladder chemotherapy after URS.

Keywords: Bladder chemoprophylaxis; Upper tract urothelial carcinoma; Ureterorenoscopy.

Publication types

  • Review

MeSH terms

  • Carcinoma, Transitional Cell* / diagnosis
  • Carcinoma, Transitional Cell* / drug therapy
  • Carcinoma, Transitional Cell* / surgery
  • Chemoprevention
  • Humans
  • Nephrectomy / methods
  • Ureteral Neoplasms* / pathology
  • Ureteral Neoplasms* / surgery
  • Urinary Bladder / pathology
  • Urinary Bladder Neoplasms* / drug therapy
  • Urinary Bladder Neoplasms* / surgery