Upper urinary tract neoplasms (pelvicalyceal system of kidney and ureters) are usually malignant tumors originating from the epithelium of the urinary tract (transitional cell carcinoma, TCC).
The location of the primary lesion can be very different, from renal calyces, through the renal pelvis to the ureteral orifice of the ureter, and very often they develop as multifocal focuses. Usually in the early stages they do not cause any signs and symptoms, and the first symptom is hematuria or impeding renal outflow in case of tumors narrowing the ureter. The first diagnostic step is performing an ultrasound of the abdominal cavity and pelvis. If ultrasound suggests tumor presence in upper urinary tract, a computed tomography or magnetic resonance tomography should be performed, which usually allow a definitive diagnosis.
Tumors located in renal calyces and pelvis and in 2/3 of the upper ureters, as well as multiple tumors, require the removal of kidney and entire ureter with part of the bladder. In case of tumors located in the lower 1/3 of the ureter, it is sometimes possible to remove part of the ureter with rosette of the bladder and re-connect the healthy part of the ureter with the bladder. The above operations usually require a one-week hospital stay. In some patients it is possible to remove minor neoplastic lesions endoscopically by ureterorenoscopy, which shortens hospitalisation time to 1-3 days. All patients after surgical treatment of upper urinary tract cancer remain under constant urological and oncological care and, if necessary, undergo additional treatment.
Qualifications for the procedures are carried out by Dr Piotr Dzigowski at the Hospital Consultation Centre, the visit lasts 20 minutes, and the cost of the visit is 190 PLN.