Wang Kai-Yun, Hu Jia-Sheng, Fang Li, Zhang Dong-Xu, Li Qiang, Ng Derry Minyao, Haleem Maria, Xie Guo-Hai, Ma Qi
Translational Research Laboratory for Urology, The Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang 315010, P.R. China.
School of Medicine, Ningbo University, Ningbo, Zhejiang 315000, P.R. China.
Exp Ther Med. 2020 Apr;19(4):2627-2631. doi: 10.3892/etm.2020.8482. Epub 2020 Jan 31.
The present study investigated the use of retrograde flexible ureteroscopy (RFU) in the discrimination of the etiology of hematuria that originates from the upper urinary tract (UUT). The present study collected retrospective data for patients who presented with hematuria and cystoscopy-detected bleeding from the UUT between June 2006 and August 2018 in Ningbo First Hospital. All patients accepted RFU to determine the etiology of hematuria. Data regarding imaging examinations, surgery, pathology and complications were also collected and analyzed. In total, 65 patients (males, 38; females, 27) with a mean age of 63 years underwent RFU to determine the etiology of hematuria originating from the UUT. Using RFU, UUT tumors were found in 29 cases. Stones, polyps and atypical hyperplasia were found in two cases, and a definite diagnosis was not found in three cases. There were 17 cases without obvious abnormalities and nine cases were unable to undergo RFU due to ureteral stenosis. In patients who could not be diagnosed by imaging examination, 34.4% (11/32) were diagnosed with urothelial carcinoma by RFU, and these results were also confirmed by postoperative pathology. In the present study, no patient had severe complications after RFU. The present results suggested RFU may be used as a sensitive method to diagnose UUT tumors (78.4%; 29/37) and has strong specificity. RFU could be performed as a routine examination for patients with hematuria from the UUT.
本研究探讨逆行性软性输尿管镜检查（RFU）在鉴别源自上尿路（UUT）血尿病因中的应用。本研究收集了2006年6月至2018年8月期间在宁波市第一医院因血尿就诊且经膀胱镜检查发现UUT出血患者的回顾性数据。所有患者均接受RFU以确定血尿病因。同时收集并分析了有关影像学检查、手术、病理及并发症的数据。共有65例患者（男性38例，女性27例），平均年龄63岁，接受RFU以确定源自UUT血尿的病因。通过RFU，发现29例UUT肿瘤。2例发现结石、息肉及非典型增生，3例未明确诊断。17例无明显异常，9例因输尿管狭窄无法接受RFU。在影像学检查无法确诊的患者中，34.4%（11/32）经RFU诊断为尿路上皮癌，术后病理也证实了这些结果。在本研究中，RFU术后无患者出现严重并发症。本研究结果提示RFU可作为诊断UUT肿瘤的敏感方法（78.4%；29/37），且具有较强的特异性。RFU可作为UUT血尿患者的常规检查。
