Resection of the Intramural Portion of the Distal Ureter during Transurethral Resection of Bladder Tumors: Predictive Factors for Secondary Stenosis and Development of Upper Urinary Tract Recurrence

The Journal of Urology
Oscar Rodriguez FabaJuan Palou

Abstract

We analyzed the incidence of and predictive factors for ureteral stenosis and recurrent upper urinary tract urothelial carcinoma after resection of tumors located in the intramural portion of the distal ureter. We retrospectively analyzed the records of 2,317 patients who underwent transurethral resection of bladder tumor for nonmuscle invasive bladder cancer, including 112 (4.83%) with tumors involving the intramural portion of the distal ureter. Multivariate Cox regression analysis was done to determine predictive factors for ureteral stenosis and recurrent urinary tract urothelial carcinoma. At a mean followup of 56 months 17 patients (15.2%) presented with recurrent upper urinary tract urothelial carcinoma and ureteral stenosis had developed in 13 (11.6%). On univariate analysis previous recurrences were associated with both events. On multivariate analysis tumor size 1.5 cm or greater (HR 4.521, p = 0.023) and T1 tumor stage (HR 8.525, p = 0.005) were independent predictive factors for stenosis. Stage T1 in the bladder (HR 7.253, p = 0.001) and carcinoma in situ in the intramural portion of the distal ureter (HR 6.850, p = 0.005) increased the risk of recurrent upper urinary tract urothelial carcinoma. The main study limit...Continue Reading

References

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