Defining the problem
Blood in the urine, a collecting-system abnormality on imaging or an abnormal urine test may lead to further investigation. Assessment can include contrast imaging where appropriate, urine cytology and ureteroscopy with tissue sampling when needed.
The grade, location and extent of the tumour help determine whether kidney-preserving treatment is reasonable.
Kidney preservation or definitive removal
Selected lower-risk tumours may be treated with an endoscopic or segmental approach. Higher-risk disease often requires removal of the kidney and ureter, including the ureter’s entry into the bladder. Lymph node surgery and systemic treatment may be considered in the appropriate setting.
The expected effect on kidney function deserves particular attention, especially if the other kidney is impaired.
A focused surgical consultation
The discussion with Dr. Sachin can cover the appropriateness of a robotic approach, the possible scope of lymph node surgery and reconstruction if part of the ureter is retained.
Bring the original imaging, ureteroscopy findings, biopsy and cytology reports, and recent kidney function results. Ask how the proposed treatment might affect future treatment options.
Looking beyond the operation
Follow-up addresses both the treated upper tract and the bladder. The final pathology and treatment received determine the monitoring plan. Ask which tests are expected, who will coordinate them and what symptoms should prompt earlier contact.
Common questions
Is this the same as renal cell cancer?
No. These cancers arise from different tissues and their investigation and treatment pathways differ.
Can the kidney sometimes be preserved?
Yes, in selected situations. The tumour’s risk and the ability to monitor and treat it adequately are central to the decision.