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Ureteroscopic Management of Chronic Unilateral Hematuria: A Single-Center Experience over 22 Years

Author

Listed:
  • Motoo Araki
  • Shinya Uehara
  • Katsumi Sasaki
  • Koichi Monden
  • Masaya Tsugawa
  • Toyohiko Watanabe
  • Manoji Monga
  • Yasutomo Nasu
  • Hiromi Kumon

Abstract

Objective: To analyze the short and long term safety and efficacy of ureteroscopic evaluation and management of chronic unilateral hematuria. Methods: 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. Results: 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

Suggested Citation

  • Motoo Araki & Shinya Uehara & Katsumi Sasaki & Koichi Monden & Masaya Tsugawa & Toyohiko Watanabe & Manoji Monga & Yasutomo Nasu & Hiromi Kumon, 2012. "Ureteroscopic Management of Chronic Unilateral Hematuria: A Single-Center Experience over 22 Years," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-6, June.
    • Handle: RePEc:plo:pone00:0036729
    DOI: 10.1371/journal.pone.0036729
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