Ureteroscopy

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

Your 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 you may take ahead of a ureteroscopy, but be sure to ask your care team for their recommendations.

1. Ask someone to take you home after the ureteroscopy.
2. Inform your care team about any medications that you use, including over-the-counter supplements or herbs.
3. Find out if there are any medications that you need to stop in advance, such as aspirin or blood thinners.
4. Ask if it’s OK to eat or drink the day of the procedure.

What to expect from a ureteroscopy

A ureteroscopy usually takes about one hour.

You may receive general anesthesia or sedation for a ureteroscopy, via an intravenous (IV) needle in your arm or hand vein. General anesthesia puts you to sleep, while sedation helps you 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. Your 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 your doctor takes a tissue sample during the procedure, a pathologist may then look at it for indications of cancer.

If you received general anesthesia, you may have to wait a couple of hours before you can leave. A health professional may ask you to urinate before you go home. On occasion, you may have to stay overnight in the hospital after having a ureteroscopy.

After a ureteroscopy, your care team may ask you 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 your urinary tract.
• Use a warm washcloth in 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 like you’ve fully recovered).

Benefits and risks of a ureteroscopy

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

General side effects of a ureteroscopy include:

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

Alert your care team if you experience any of these symptoms:

• 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.

Reviewing the results of a ureteroscopy

Discuss the results from a ureteroscopy with your doctor. Make sure to ask any questions that you have.

Your doctor 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 your care team determine a 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 as the most advanced—or the use of the terms localized, regional, metastatic or recurrent.

A combination of test results may help your care team decide how to approach cancer treatment. Surgery, regional chemotherapy and regional biologic therapy are among the 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 your care team about possible clinical trials that may be right for you.